Individual provider Active NPI

Melody J. Shubert, DC

  • Internist Chiropractor
  • Wichita, KS
National Provider Identifier
1407955396
Registry record updated Jun 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internist ChiropractorTaxonomy code 111NI0900X
License
C-3869 Issued in KS
Practice address
2456 N Woodlawn Blvd
Suite 5C
Wichita, KS 67220-3968
Phone
(316) 636-4444
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internist Chiropractor 111NI0900X C-3869 KS Primary

Addresses

Primary practice location

2456 N Woodlawn Blvd
Suite 5C
Wichita, KS 67220-3968

Mailing address

2456 N Woodlawn Blvd
Suite 5C
Wichita, KS 67220-3968
Phone (316) 636-4444

Other identifiers 1

IdentifierTypeStateIssuer
55007OtherKSBLUE CROSS BLUE SHEILD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050701000784 KS Practitioner - Chiropractic 4082650825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1987
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2456 N Woodlawn Blvd
Suite 5C
Wichita, KS 67220-3968
Phone (316) 636-4444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-3869KSMDInternist Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Shubert Chiropractic PA CurrentSince Oct 1, 2012 Accepting new patients

Locations

3101 N Rock Rd
Ste 100
Wichita, KS 67226
Phone (216) 636-4444

2456 N Woodlawn Blvd
Ste 5C
Wichita, KS 67220
Phone (316) 636-4444

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1407955396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2456 N WOODLAWN BLVD",
            "address_2": "SUITE 5C",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672203968",
            "telephone_number": "316-636-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2456 N WOODLAWN BLVD",
            "address_2": "SUITE 5C",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672203968",
            "telephone_number": "316-636-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUBERT",
        "first_name": "MELODY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "KS",
            "license": "C-3869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "55007",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.