Active NPI
Stephen W Shea, D.O.
- Orthopaedic Surgery Physician
- Brookings, OR
National Provider Identifier
1245226935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- DO22320
- Practice address
- 500 5TH St
Brookings, OR 97415-9702 - Phone
- (541) 412-2000
- Fax
- (541) 412-2081
- NPI assigned
- Sep 27, 2005
- 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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 48512-021 | WI | |
| Orthopaedic Surgery Physician | 207X00000X | DO22320 | OR | Primary |
Addresses
Primary practice location
500 5TH St
Brookings, OR 97415-9702
Mailing address
94220 4TH St
Gold Beach, OR 97444-7756
Phone (541) 247-3000
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R179204 | Other | OR | MEDICARE FOR RSC |
| 14879696985 | Other | OR | CURRY HEALTH DISTRICT |
| 130298 | Medicaid | OR | |
| R179202 | Other | OR | MEDICARE FOR CHD |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48512-021 | WI | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439856000000",
"number": "1245226935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94220 4TH ST",
"city": "GOLD BEACH",
"state": "OR",
"postal_code": "974447756",
"telephone_number": "541-247-3000",
"fax_number": "541-247-3101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 5TH ST",
"city": "BROOKINGS",
"state": "OR",
"postal_code": "974159702",
"telephone_number": "541-412-2000",
"fax_number": "541-412-2081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEA",
"first_name": "STEPHEN",
"middle_name": "W",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-27",
"last_updated": "2015-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "WI",
"license": "48512-021",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "OR",
"license": "DO22320",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE FOR RSC",
"identifier": "R179204",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CURRY HEALTH DISTRICT",
"identifier": "14879696985",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "130298",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE FOR CHD",
"identifier": "R179202",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookings, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.