Shane Andrew Kavanaugh, M.S., LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

001560 Issued in IA

Practice address

125 S 3Rd St
Ames, IA 50010-7042

Phone

(515) 661-4210

NPI assigned

Sep 25, 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 OR, WA2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/yss/r4/

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  WA

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD
• Manor Care of Salmon Creek Wa, Association

  • Skilled Nursing Facility
  • Vancouver, WA
  • NPI 1609171081
  NPD
• Youth and Shelter Services, Inc.

  • Counselor
  • Ames, IA
  • NPI 1841357894

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1356692792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S 3RD ST",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500107042",
            "telephone_number": "515-661-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S 3RD ST",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500107042",
            "telephone_number": "515-661-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "SHANE",
        "middle_name": "ANDREW",
        "credential": "M.S., LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-25",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jody L Kapustka, ARNP
• Johnathan T Kash
• Sarkis Kaspar, M.D.
• Kathy May Counseling, PLLC
• Analissa M Kautza, ARNP
• John B Kazwell, DDS
• John Joseph Kearney, DDS
• Kathryn R Kearney, D.D.S.
• Moira Katherine Keech
• Kaitlin Marie Keeling

• Mental Health Counselor in Ames, IA
• Providers in Ames, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; 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.