Eugene Herman Shively, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

15931 Issued in KY

Practice address

1698 Old Lebanon Rd
Suite 2a
Campbellsville, KY 42718-9662

Phone

(270) 465-2821

Fax

(270) 789-1756

NPI assigned

Dec 14, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/janetod-f1571d3c

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.

• Jane Todd Crawford Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Greensburg, KY
  • NPI 1144296658

  KY

  Medicare reassignment NPD
• Taylor Regional Medical Group, LLC

  • Family Medicine Physician
  • Campbellsville, KY
  • NPI 1699030031

  KY

  Medicare reassignment NPD
• Taylor Regional Medical Group,LLC

  • Obstetrics & Gynecology Physician
  • Campbellsville, KY
  • NPI 1174697601

  KY

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  KY

  Medicare reassignment NPD
• Jane Todd Crawford Memorial Hospital, Inc.

  • Anesthesiology Physician
  • Greensburg, KY
  • NPI 1154585289
  NPD
• Taylor Regional Medical Group LLC

  • Rural Health Clinic/Center
  • Campbellsville, KY
  • NPI 1073370185
  NPD
• Taylor Regional Medical Group,LLC

  • Plastic Surgery Physician
  • Campbellsville, KY
  • NPI 1720376411
  NPD
• University Surgical Associates, PSC

  • Surgery Physician
  • Louisville, KY
  • NPI 1609847367

  Surgery

  NPD (past)

Merit-based Incentive Payment System (MIPS)

Final score

92.9 of 100Reported as group

Quality

85.93

Improvement activities

40

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1396720132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1698 OLD LEBANON RD",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189662",
            "telephone_number": "270-465-2821",
            "fax_number": "270-789-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1698 OLD LEBANON RD",
            "address_2": "SUITE 2A",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189662",
            "telephone_number": "270-465-2821",
            "fax_number": "270-789-1756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVELY",
        "first_name": "EUGENE",
        "middle_name": "HERMAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "15931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64159312",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tameron C Shaw, APRN
• Whitney Lynn Shepard, M.D.
• Amanda Rose Shepperd, APRN
• Linda K Shipp, RPH
• Samantha Shipp
• Laree Shively, APRN
• Susan Ashley Shively, CRNFA, MSN, FNP-C
• Gail Shofner
• Lyndsie Short, ATC
• Barbara Natalie Shuffett, APRN

• All providers in Campbellsville, KY
• Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; 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.