Individual provider Active NPI

Shaun Matthew White, PA

  • Surgical Physician Assistant
  • Batavia, OH
National Provider Identifier
1558392894
Registry record updated Nov 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50.002125 Issued in OH
Practice address
3000 Hospital Dr
Batavia, OH 45103-1921
Phone
(513) 732-8278
Fax
(513) 732-8537
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50.002125 OH Primary

Addresses

Primary practice location

3000 Hospital Dr
Batavia, OH 45103-1921

Mailing address

7222 Mariemont Cres
Cincinnati, OH 45227-3932
Phone (513) 746-9228

Other identifiers 1

IdentifierTypeStateIssuer
000000588608OtherOHANTHEM PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Consultants of Cincinnati, Inc. Past Accepting new patients

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226880000000",
    "number": "1558392894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7222 MARIEMONT CRES",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452273932",
            "telephone_number": "513-746-9228",
            "fax_number": "513-732-8537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 HOSPITAL DR",
            "city": "BATAVIA",
            "state": "OH",
            "postal_code": "451031921",
            "telephone_number": "513-732-8278",
            "fax_number": "513-732-8537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "SHAUN",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.002125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000588608",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Batavia, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.