Individual provider Active NPI

Priscilla Moutinho Shogan, DO

  • Emergency Medicine Physician
  • Owings Mills, MD
National Provider Identifier
1528242765
Registry record updated Apr 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
H006810 Issued in MD
Practice address
5 Silentwood CT
Owings Mills, MD 21117-1358
Phone
(215) 917-5011
NPI assigned
Dec 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OT011586 PA
Emergency Medicine Physician 207P00000X H006810 MD Primary

Addresses

Primary practice location

5 Silentwood CT
Owings Mills, MD 21117-1358

Mailing address

5 Silentwood CT
Owings Mills, MD 21117-1358
Phone (215) 917-5011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20110616000775 TN Practitioner - Emergency Medicine 6103972740 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Philadelphia College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of TN, PCGroup PAC ID 3173989837, 144 clinicians

Practice addresses (Care Compare)

107 Natchez Park Dr
Tristar Natchez ER
Dickson, TN 37055-9013
Phone (615) 326-2960

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H006810MDMDEmergency Medicine Physician
OT011586PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of TN, PC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince May 20, 2011 Accepting new patients
Dimensions Health Corporation Emergency Medicine Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

107 Natchez Park Dr
Dickson, TN 37055
Phone (615) 326-2900

111 Highway 70 E
Dickson, TN 37055
Phone (615) 441-2357

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271203200000",
    "number": "1528242765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SILENTWOOD CT",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211171358",
            "telephone_number": "215-917-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SILENTWOOD CT",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211171358",
            "telephone_number": "215-917-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUTINHO SHOGAN",
        "first_name": "PRISCILLA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-24",
        "last_updated": "2010-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT011586",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "H006810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

Verify at the official NPI Registry.