Brian Shue, MD

Primary specialty

DentistTaxonomy code 122300000X

License

CA41548 Issued in CA

Practice address

1166 K St
Brawley, CA 92227-2737

Phone

(760) 344-9951

NPI assigned

Jan 3, 2007

Last updated

Dec 21, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: brian.shue.p1@direct.cdsdp.nextgenshare.com

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1235296898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 K ST",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922272737",
            "telephone_number": "760-344-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1166 K ST",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922272737",
            "telephone_number": "760-344-9951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUE",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "CA41548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "CA41548",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Matthew Scholl, PA
• Natalie Marie Serra, CRNA
• Melinda Serrano, CRNA
• Shannon J Daughtry DDS Inc
• Shelly Sharma, PHARMD
• Kristina Silva
• Mark Simpson, PA-C
• Liliana Siordia-Ramirez, LMFT
• Marc Theodore Soriano
• Savanna Marie Soto

• Dentist in Brawley, CA
• Providers in Brawley, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.