Active NPI
Katherine M. Shiue, M.D.
- Pediatrics Physician
- Cottleville, MO
National Provider Identifier
1306814587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 113981
- Practice address
- 4525 Mid Rivers Mall Dr
Suite 20
Cottleville, MO 63376-2820 - Phone
- (636) 441-5437
- Fax
- (636) 441-4398
- NPI assigned
- Mar 14, 2006
- Last updated
- Jan 22, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 113981 | MO | Primary |
Addresses
Primary practice location
4525 Mid Rivers Mall Dr
Suite 20
Cottleville, MO 63376-2820
Mailing address
4525 Mid Rivers Mall Dr
Suite 20
Cottleville, MO 63376-2820
Phone (636) 441-5437
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306814587 | Medicaid | MO |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113981 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic East Communities | Pediatrics | Past | Accepting new patients |
| Mercy Hospitals East Communities | Past | Accepting new patients |
Interoperability endpoints
- kshiue228@directc.mercy.net
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Mercy St. Louis Transport Ambulance
- Land Ambulance
- Saint Louis, MO
- NPI 1881329902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421884800000",
"number": "1306814587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4525 MID RIVERS MALL DR",
"address_2": "SUITE 20",
"city": "COTTLEVILLE",
"state": "MO",
"postal_code": "633762820",
"telephone_number": "636-441-5437",
"fax_number": "636-441-4398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4525 MID RIVERS MALL DR",
"address_2": "SUITE 20",
"city": "COTTLEVILLE",
"state": "MO",
"postal_code": "633762820",
"telephone_number": "636-441-5437",
"fax_number": "636-441-4398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIUE",
"first_name": "KATHERINE",
"middle_name": "M.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-14",
"last_updated": "2015-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "113981",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306814587",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cottleville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.