Robert Corry Shumate, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12012662A Issued in IN

Practice address

4121 Gateway Blvd
Newburgh, IN 47630-8954

Phone

(812) 858-3100

Fax

(812) 858-3100

NPI assigned

May 27, 2012

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

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Oral SurgeryAlso: Maxillofacial Surgery

Education

Nova Southeastern Univ College of Dental Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oral Surgery Group of Evansville IncGroup PAC ID 5991880106, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Oral Surgery Group of Evansville, Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Evansville, IN
  • NPI 1467506188
  Medicare reassignment Care Compare group NPD

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

• Deaconess Hospital Inc

  • General Acute Care Hospital
  • Newburgh, IN
  • NPI 1780535427
  Care Compare affiliation
• Deaconess Hospital, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1053361642
  Care Compare affiliation

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

{
    "created_epoch": "1338076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1255691085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308954",
            "telephone_number": "812-858-3100",
            "fax_number": "812-858-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308954",
            "telephone_number": "812-858-3100",
            "fax_number": "812-858-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 W Virginia St",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477101684",
            "country_code": "US",
            "telephone_number": "812-425-9199",
            "fax_number": "812-858-3110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUMATE",
        "first_name": "ROBERT",
        "middle_name": "CORRY",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-27",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12012662A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek S Shelton, ARNP
• Kimberly S. Shimer, MD
• Daniel Ray Shirey, MD
• Bailey Shoulders, RBT
• Samantha Elaine Shoultz, NP
• Irfan Ahmed Siddiqui, M.D.
• Daniel Sigler
• Savannah Sikes
• Elisa Simmons, RDN, CDN
• Michelle L Simon, PTA

• Oral and Maxillofacial Surgery (Dentist) in Newburgh, IN
• Providers in Newburgh, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.