Mark Edward Shockley, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

01047527A Issued in IN

Practice address

3700 Washington Ave
Evansville, IN 47714-0541

Phone

(812) 473-0181

Fax

(812) 473-5822

NPI assigned

Oct 31, 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 5

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Anesthesiology

Education

University of Kentucky College of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesiology Group Associates PCGroup PAC ID 0547233959, 47 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent Evansville Hospital, Evansville, IN, CCN 150100

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.

• Anesthesiology Group Associates PC

  • Anesthesiology Physician
  • Evansville, IN
  • NPI 1194761262
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Mary'S Health, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1427082957
  Care Compare affiliation

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306368000000",
    "number": "1437140365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3276",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477313276",
            "telephone_number": "812-473-0181",
            "fax_number": "812-473-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140541",
            "telephone_number": "812-473-0181",
            "fax_number": "812-473-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCKLEY",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2011-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01047527A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64297914",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - DEACONESS GATEWAY",
            "identifier": "000000501013",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "000000184048",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200155630",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - DEACONESS MARY ST",
            "identifier": "000000193493",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Curtis E Shinabarger, M.D.
• Diksha K Shinde
• Harold Shines Jr., LSW
• Christina Lee Shipley-Walters, LPN
• Christopher Shivers
• Sholar Center for Aesthetic Surgery
• April J Shoulders, NP
• Debra Kay Shoulders, ARNP
• Mindy Sue Shoulders, NP
• Christopher C Shrack, DO

• Anesthesiology Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Anesthesiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; 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.