Individual provider Active NPI

Shannon M Tighe, MD

  • Pediatrics Physician
  • Indianapolis, IN
National Provider Identifier
1508807215
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01061627A Issued in IN
Practice address
8150 Oaklandon Road
Suite 130
Indianapolis, IN 46236-9554
Phone
(317) 621-7111
Fax
(317) 621-7110
NPI assigned
Jun 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 01061627A IN Primary

Addresses

Primary practice location

8150 Oaklandon Road
Suite 130
Indianapolis, IN 46236-9554

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2890
Phone (317) 621-0868

Other identifiers 3

IdentifierTypeStateIssuer
7898849OtherINAETNA
000000624364OtherINANTHEM
200831060MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stighe10117@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070129000412 IN Practitioner - Pediatric Medicine 4183625494 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01061627AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc Pediatrics CurrentSince Mar 16, 2011 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Mar 16, 2011 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

8150 Oaklandon Rd
Ste 130
Indianapolis, IN 46236
Phone (317) 621-1111

Interoperability endpoints

  • Direct secure messaging: stighe10117@ecommunitydirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1508807215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-0868",
            "fax_number": "317-621-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8150 OAKLANDON ROAD",
            "address_2": "SUITE 130",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462369554",
            "telephone_number": "317-621-7111",
            "fax_number": "317-621-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIGHE",
        "first_name": "SHANNON",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01061627A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7898849",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000624364",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200831060",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stighe10117@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "8150 Oaklandon Road",
            "address_2": "Suite 130",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462369554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.