Individual provider Active NPI

Tanya Shoaib, M.D.

  • Internal Medicine Physician
  • Bowling Green, KY
National Provider Identifier
1235428574
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
47560 Issued in KY
Practice address
407 Autumnstone LN
Bowling Green, KY 42103-6004
Phone
(952) 381-1344
NPI assigned
Apr 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 47560 KY Primary

Addresses

Primary practice location

407 Autumnstone LN
Bowling Green, KY 42103-6004

Mailing address

407 Autumnstone LN
Bowling Green, KY 42103-6004
Phone (952) 381-1344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20150323001483 KY Practitioner - Internal Medicine 4688991136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

250 Park St
Bowling Green, KY 42101-1760
Phone (270) 796-6540

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47560KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Health Corporation, Inc. CurrentSince Apr 1, 2016 Accepting new patients
Commonwealth Health Corporation, Inc. CurrentSince Apr 1, 2016 Accepting new patients
Commonwealth Health Corporation, Inc Current Accepting new patients
Bowling Green-Warren County Community Hospital Corporation Past Accepting new patients

Locations

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

250 Park St
Ste 204
Bowling Green, KY 42101
Phone (270) 796-6540

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

Organizations & group practices 4

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1235428574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 AUTUMNSTONE LN",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421036004",
            "telephone_number": "952-381-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 AUTUMNSTONE LN",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421036004",
            "telephone_number": "952-381-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOAIB",
        "first_name": "TANYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-06",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "47560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.