Individual provider Active NPI

Michael W Shull, D.O.

  • Pediatrics Physician
  • Garden City, KS
National Provider Identifier
1427000900
Registry record updated Apr 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
05-22568 Issued in KS
Practice address
311 E Spruce St
Garden City, KS 67846
Phone
(620) 275-3730
NPI assigned
May 16, 2006
Last updated
Apr 25, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 05-22568 KS Primary

Addresses

Primary practice location

311 E Spruce St
Garden City, KS 67846

Mailing address

311 E Spruce St
Garden City, KS 67846
Phone (620) 275-3730

Other identifiers 1

IdentifierTypeStateIssuer
100230520BMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05-22568KSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Catherine Hospital Pediatrics CurrentSince Apr 30, 2003 Accepting new patients
Commonspirit Kansas, Inc. Current Accepting new patients
Commonspirit Kansas, Inc. Pediatrics CurrentSince Feb 1, 2017 Accepting new patients

Locations

100 W Ross Blvd
Ste 1B
Dodge City, KS 67801
Phone (620) 371-5576

311 E Spruce St
Garden City, KS 67846
Phone (620) 275-3030

401 E Spruce St
Garden City, KS 67846
Phone (620) 272-2222

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366848000000",
    "number": "1427000900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 E SPRUCE ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "67846",
            "telephone_number": "620-275-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 E SPRUCE ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "67846",
            "telephone_number": "620-275-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULL",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2013-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "05-22568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100230520B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, KS

Sources for this page

Verify at the official NPI Registry.