NPIMap

Individual provider Active NPI

Thomas Shaughnessy, M.D.

  • Nephrology Physician
  • Edgewood, KY
National Provider Identifier
1326083379
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
35-053140 Issued in OH
Practice address
830 Thomas More Pkwy Ste 202
Edgewood, KY 41017-5103
Phone
(859) 341-6281
Fax
(859) 341-4661
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35-053140 OH Primary
Nephrology Physician 207RN0300X 21833 KY
Nephrology Physician 207RN0300X 01034872 IN

Addresses

Primary practice location

830 Thomas More Pkwy Ste 202
Edgewood, KY 41017-5103

Mailing address

4600 Montgomery Rd
Ste 105
Cincinnati, OH 45212-2697
Phone (513) 487-5305

Other identifiers 1

IdentifierTypeStateIssuer
0642611MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111215000701 KY Practitioner - Nephrology 9032173224 Reassigns benefits to 1 organization
I20111219000948 OH Practitioner - Nephrology 9032173224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Louisville School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kidney and Hypertension Center IncGroup PAC ID 9830099985, 47 clinicians

Practice addresses (Care Compare)

2123 Auburn Ave
Suite 404
Cincinnati, OH 45219-2906
Phone (513) 241-5630

830 Thomas More Pkwy
Suite 202
Edgewood, KY 41017-5103
Phone (859) 341-6281

Hospital & facility affiliations

  • DaVita Crestview Hills Dialysis Dialysis facility, Crestview Hills, KY, CCN 182529
  • DaVita Turfway Dialysis Dialysis facility, Florence, KY, CCN 182582
  • DaVita Walton Dialysis Dialysis facility, Walton, KY, CCN 182636
  • DaVita Cold Spring Dialysis Dialysis facility, Cold Spring, KY, CCN 182583
  • St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035
  • St Elizabeth Florence Hospital, Florence, KY, CCN 180045
  • St Elizabeth Grant Hospital, Williamstown, KY, CCN 181311
  • St Elizabeth Ft Thomas Hospital, Fort Thomas, KY, CCN 180001
  • Christ Hospital Hospital, Cincinnati, OH, CCN 360163

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01034872INMDNephrology Physician
35-053140OHMDNephrology Physician

Interoperability endpoints

  • Direct secure messaging: thomasshaughnessy@tkhc.allscriptsdirect.net
  • Direct secure messaging: tshaughnessy26731@direct-prd.stelizabeth.com

Organizations & group practices 1

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 8

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1326083379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MONTGOMERY RD",
            "address_2": "STE 105",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122697",
            "telephone_number": "513-487-5305",
            "fax_number": "513-487-5317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 THOMAS MORE PKWY STE 202",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175103",
            "telephone_number": "859-341-6281",
            "fax_number": "859-341-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAUGHNESSY",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35-053140",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "KY",
            "license": "21833",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IN",
            "license": "01034872",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0642611",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.