Individual provider Active NPI

Adrianna Cleopatra Shuey, DO

  • Internal Medicine Physician
  • Creston, IA
National Provider Identifier
1164942371
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO-05523 Issued in IA
Practice address
1700 W Townline St
Creston, IA 50801-1054
Phone
(641) 782-2131
Fax
(641) 782-6425
NPI assigned
Jun 20, 2017
Last updated
Apr 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 7996 NE
Internal Medicine Physician 207R00000X DO-05523 IA Primary

Addresses

Primary practice location

1700 W Townline St
Creston, IA 50801-1054

Mailing address

1700 W Townline St
Creston, IA 50801-1054
Phone (641) 782-7091

Other identifiers 1

IdentifierTypeStateIssuer
1164942371MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200710000761 IA Practitioner - Internal Medicine 2668746843 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
7996NEMDClinical Social Worker
DO-05523IAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Greater Regional Medical Center CurrentSince Jul 1, 2020 Accepting new patients
Greater Regional Medical Center CurrentSince Jul 1, 2020 Accepting new patients

Locations

700 Davis Ave
Corning, IA 50841
Phone (641) 322-4431

1610 W Townline St
Creston, IA 50801
Phone (641) 782-2131

1610 W Townline St
Ste 100
Creston, IA 50801
Phone (641) 782-3877

1700 W Townline St
Creston, IA 50801
Phone (641) 782-7091

288 Public Sq
Greenfield, IA 50849
Phone (641) 743-6529

Interoperability endpoints

  • Direct secure messaging: ashuey736982@direct.unitypoint.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Corning Medical ClinicCorning, IA, CCN 168636 Rural health clinic W-2 Managing Employee
Operational/Managerial Control
Jun 1, 2021
Jun 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1164942371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W TOWNLINE ST",
            "city": "CRESTON",
            "state": "IA",
            "postal_code": "508011054",
            "telephone_number": "641-782-7091",
            "fax_number": "641-782-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W TOWNLINE ST",
            "city": "CRESTON",
            "state": "IA",
            "postal_code": "508011054",
            "telephone_number": "641-782-2131",
            "fax_number": "641-782-6425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUEY",
        "first_name": "ADRIANNA",
        "middle_name": "CLEOPATRA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "7996",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "DO-05523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164942371",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Creston, IA

Sources for this page

Verify at the official NPI Registry.