NPIMap

Individual provider Active NPI

Kelly Shum, MD

  • Cardiovascular Disease Physician
  • The Woodlands, TX
National Provider Identifier
1366886178
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
S1273 Issued in TX
Practice address
17350 St Lukes Way Ste 400
The Woodlands, TX 77384-4167
Phone
(362) 664-8009
Fax
(936) 266-4775
NPI assigned
Apr 23, 2013
Last updated
Aug 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X S1273 TX
Cardiovascular Disease Physician 207RC0000X S1273 TX Primary

Addresses

Primary practice location

17350 St Lukes Way Ste 400
The Woodlands, TX 77384-4167

Mailing address

17350 St Lukes Way Ste 400
The Woodlands, TX 77384-4167
Phone (936) 266-4909

Other practice location 1

1514 Jefferson Hwy
Jefferson, LA 70121-2429
Phone (504) 842-3000

Other practice location 2

2255 E Mossy Oaks Rd Ste 600
Spring, TX 77389-1813
Phone (936) 266-4800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191001003397 TX Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1456575778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor St. Luke's Medical GroupGroup PAC ID 9133213192, 172 clinicians

Practice addresses (Care Compare)

2255 E Mossy Oaks Rd
Suite 320
Spring, TX 77389-1812
Phone (936) 266-2190

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S1273TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor St. Luke's Medical Group Internal Medicine CurrentSince Jul 2, 2024 Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients

Locations

1 Baylor Plz
#2
Houston, TX 77030

20207 Chasewood Park Dr
Ste 300
Houston, TX 77070
Phone (832) 534-7800

6624 Fannin St
Ste 1240
Houston, TX 77030
Phone (832) 355-5575

521 Interstate 45 S
Huntsville, TX 77340
Phone (936) 293-8800

2255 E Mossy Oaks Rd
Ste 320
Spring, TX 77389
Phone (832) 534-7860

2255 E Mossy Oaks Rd
Ste 600
Spring, TX 77389
Phone (936) 266-4800

17198 St Lukes Way
Ste 440
The Woodlands, TX 77384
Phone (936) 266-2500

17350 St Lukes Way
Ste 400
The Woodlands, TX 77384
Phone (832) 249-3721

9851 FM 1097 Rd W
Ste 100
Willis, TX 77318

Interoperability endpoints

  • Direct secure messaging: hmhkshum@yourcarecommunity.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/JIHBCA

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.

Hospital & facility affiliations 10

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": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1366886178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17350 ST LUKES WAY STE 400",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844167",
            "telephone_number": "936-266-4909",
            "fax_number": "936-266-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17350 ST LUKES WAY STE 400",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844167",
            "telephone_number": "362-664-8009",
            "fax_number": "936-266-4775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1514 Jefferson Hwy",
            "address_purpose": "LOCATION",
            "city": "Jefferson",
            "state": "LA",
            "postal_code": "701212429",
            "country_code": "US",
            "telephone_number": "504-842-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2255 E Mossy Oaks Rd Ste 600",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773891813",
            "country_code": "US",
            "telephone_number": "936-266-4800",
            "fax_number": "936-266-4775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUM",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-23",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S1273",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "S1273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

Verify at the official NPI Registry.