Individual provider Active NPI

Ronald C Shrum, DDS

  • Dentist
  • Blue Springs, MO
National Provider Identifier
1174827075
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11972 Issued in MO
Practice address
1938 NW Copper Oaks Cir
Blue Springs, MO 64015-8300
Phone
(816) 229-7575
Fax
(816) 229-8192
NPI assigned
Jan 6, 2011
Last updated
Jan 6, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11972 MO Primary

Addresses

Primary practice location

1938 NW Copper Oaks Cir
Blue Springs, MO 64015-8300

Mailing address

1938 NW Copper Oaks Cir
Blue Springs, MO 64015-8300
Phone (816) 229-7575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11972MOMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1294272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294272000000",
    "number": "1174827075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1938 NW COPPER OAKS CIR",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640158300",
            "telephone_number": "816-229-7575",
            "fax_number": "816-229-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1938 NW COPPER OAKS CIR",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640158300",
            "telephone_number": "816-229-7575",
            "fax_number": "816-229-8192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRUM",
        "first_name": "RONALD",
        "middle_name": "C",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-06",
        "last_updated": "2011-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "11972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.