Kathryn Sara Shanahan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1828 Issued in NE

Practice address

727 N 120TH St
Omaha, NE 68154-4212

Phone

(402) 493-2100

NPI assigned

Aug 28, 2014

Last updated

Aug 28, 2014By the provider in NPPES

Sex

Female

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 NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hydr8 LLCGroup PAC ID 1456726884, 18 clinicians

4G Enterprises LLCGroup PAC ID 4789810508, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 4G Enterprises, LLC

  dba Rockbrook Urgent Care

  • Urgent Care Clinic/Center
  • Omaha, NE
  • NPI 1033544267
  Medicare reassignment Care Compare group
• Hydr8, LLC

  dba West Omaha Urgent Care

  • Urgent Care Clinic/Center
  • Omaha, NE
  • NPI 1922735406
  Medicare reassignment Care Compare group
• Harlan Medical, LLC

  dba Bellevue Urgent Care

  • Urgent Care Clinic/Center
  • Bellevue, NE
  • NPI 1487089611
  Medicare reassignment
• Make Medical, LLC

  dba Urgent Care Network Crossroads

  • Urgent Care Clinic/Center
  • Omaha, NE
  • NPI 1295181022
  Medicare reassignment
• Bellevue Urgent Care LP

  • Urgent Care Clinic/Center
  • Bellevue, NE
  • NPI 1861632127
  NPD
• Legacy Eyecare, LLC

  • Optometrist
  • Omaha, NE
  • NPI 1790718328
  NPD (past)

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409184000000",
    "number": "1336549211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 N 120TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681544212",
            "telephone_number": "402-493-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 N 120TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681544212",
            "telephone_number": "402-493-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "KATHRYN",
        "middle_name": "SARA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2014-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kami Marie Shalhoob, OTR/L
• Shalom Home Care LLC
• Katie Jo Shalon, PT, DPT
• Trevor Shamblee
• Sha Shan
• Jessica Barbara Shank, M.D.
• Nathan Thomas Shank, APRN
• Bikash Shankar
• Dilu Shankar
• Om Shankar

• Medical Physician Assistant in Omaha, NE
• Providers in Omaha, NE by specialty
• Medical Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; 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.