NPIMap

Individual provider Active NPI

Shelby K Raiser, DO

  • Family Medicine Physician
  • Thornville, OH
National Provider Identifier
1396725271
Registry record updated May 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34008545 Issued in OH
Practice address
41 Foster Dr
Thornville, OH 43076-8010
Phone
(740) 246-6361
Fax
(740) 246-4722
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34008545 OH Primary

Addresses

Primary practice location

41 Foster Dr
Thornville, OH 43076-8010

Mailing address

PO Box 1821
Zanesville, OH 43702-1821
Phone (740) 455-3304

Other identifiers 3

IdentifierTypeStateIssuer
000000592373OtherANTHEM
311518750029OtherOHCARESOURCE
2622899MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20051208000393 OH Practitioner - Family Practice 0648291468 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Group of Southeastern Ohio IncGroup PAC ID 8628232469, 61 clinicians

Practice addresses (Care Compare)

41 Foster Dr
Thornville, OH 43076-8010
Phone (740) 455-3304

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thornville Family Medical Center Inc Family Medicine CurrentSince Aug 1, 2005 Accepting new patients
Medical Home Primary Care Center Family Medicine Current Accepting new patients
Genesis Professional Corp Family Medicine Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3620 Court Dr
Ste K
Zanesville, OH 43701
Phone (740) 454-1248

Interoperability endpoints

  • Direct secure messaging: shelby.raiser.p16@direct.pgseo.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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 6

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367366400000",
    "number": "1396725271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1821",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437021821",
            "telephone_number": "740-455-3304",
            "fax_number": "740-455-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 FOSTER DR",
            "city": "THORNVILLE",
            "state": "OH",
            "postal_code": "430768010",
            "telephone_number": "740-246-6361",
            "fax_number": "740-246-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAISER",
        "first_name": "SHELBY",
        "middle_name": "K",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2013-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34008545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000592373",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "311518750029",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2622899",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornville, OH

Sources for this page

Verify at the official NPI Registry.