Kristy Kate Shutts, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

39531 Issued in KY

Practice address

4851 Ky Route 321
Prestonsburg, KY 41653-9113

Phone

(606) 886-1173

Fax

(606) 886-2193

NPI assigned

Nov 1, 2006

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

Other identifiers 2

Other names 1

• Kristy Kate Miller Former name

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

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 and National Provider Directory roles.

• Eastern Kentucky Tender Care Pediatrics LLC

  • Rural Health Clinic/Center
  • Prestonsburg, KY
  • NPI 1043437254

  Pediatrics

  Medicare reassignment NPD
• Frontier Medical Associates of Prestonsburg Inc

  • Rural Health Clinic/Center
  • Prestonsburg, KY
  • NPI 1447840798
  Medicare reassignment NPD
• Highlands Center for Autism, Inc

  • Clinical Psychologist
  • Prestonsburg, KY
  • NPI 1396987475
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1407933187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 697",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416530697",
            "telephone_number": "606-886-1173",
            "fax_number": "606-886-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4851 KY ROUTE 321",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416539113",
            "telephone_number": "606-886-1173",
            "fax_number": "606-886-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTTS",
        "first_name": "KRISTY",
        "middle_name": "KATE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "39531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64126451",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100004160",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTY",
            "last_name": "MILLER",
            "middle_name": "KATE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sabrina Shortridge
• Tiffany Shouse
• Jeannette Shuab
• Tamra Shultz
• Tabatha Ann Shumate, PSS
• Annmichael Siewart
• Ayesha M Sikder, M.D.
• Crystal Simmons
• Kendra Simpkins
• Lovella Simpkins

• Pediatrics Physician in Prestonsburg, KY
• Providers in Prestonsburg, KY by specialty
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.