Active NPI
Kevin P. Sheahan, MD
- General Practice Physician
- Dover, DE
National Provider Identifier
1184715591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- C10004628
- Practice address
- Nemours Pediatrics Dover
102 W. Water Street Suite 1
Dover, DE 19904-6750 - Phone
- (302) 672-5650
- Fax
- (302) 672-5655
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | C10004628 | DE | |
| General Practice Physician | 208D00000X | C10004628 | DE | Primary |
Addresses
Primary practice location
Nemours Pediatrics Dover
102 W. Water Street Suite 1
Dover, DE 19904-6750
Mailing address
PO Box 191
Provider Enrollment Dept
Rockland, DE 19732-0191
Phone (302) 651-6212
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001634033 | Medicaid | PA | |
| 4173007 | Medicaid | MD | |
| 7224001 | Medicaid | NJ |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- ksheahan649@direct.nemours.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315612800000",
"number": "1184715591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 191",
"address_2": "PROVIDER ENROLLMENT DEPT",
"city": "ROCKLAND",
"state": "DE",
"postal_code": "197320191",
"telephone_number": "302-651-6212",
"fax_number": "302-651-4945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NEMOURS PEDIATRICS DOVER",
"address_2": "102 W. WATER STREET SUITE 1",
"city": "DOVER",
"state": "DE",
"postal_code": "199046750",
"telephone_number": "302-672-5650",
"fax_number": "302-672-5655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEAHAN",
"first_name": "KEVIN",
"middle_name": "P.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2011-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "DE",
"license": "C10004628",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "DE",
"license": "C10004628",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001634033",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4173007",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7224001",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dover, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.