Individual provider Active NPI

Shawn Travis Greathouse, MD

  • Plastic Surgery Physician
  • Richmond, IN
National Provider Identifier
1578720702
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
01073741A Issued in IN
Practice address
1911 Chester Blvd
Richmond, IN 47374-1212
Phone
(765) 962-4872
Fax
(765) 935-8913
NPI assigned
May 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 01073741A IN Primary

Addresses

Primary practice location

1911 Chester Blvd
Richmond, IN 47374-1212

Mailing address

1100 Reid Pkwy
Medical Staff Services
Richmond, IN 47374-1157
Phone (765) 962-4872

Other identifiers 2

IdentifierTypeStateIssuer
000000951920OtherANTHEM
201241270MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sgreathouse301006@ReidHealth.direct-ci.com Reid Physician Associates, 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
I20150731015994 IN Practitioner - Plastic and Reconstructive Surgery 2163669052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Indiana University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reid Physician Associates IncGroup PAC ID 6406910769, 427 clinicians

Practice addresses (Care Compare)

1911 Chester Blvd
Richmond, IN 47374-1212
Phone (765) 962-4872

Hospital & facility affiliations

  • Reid Health Hospital, Richmond, IN, CCN 150048

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy15
Melanoma (skin cancer) excision66
Removal of tissue132
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01073741AINMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reid Physician Associates, Inc. CurrentSince Aug 24, 2015 Accepting new patients
Reid Physician Associates, Inc CurrentSince Aug 24, 2015 Accepting new patients

Locations

1100 Reid Pkwy
Richmond, IN 47374
Phone (765) 983-3000

1911 Chester Blvd
Richmond, IN 47374
Phone (765) 939-7711

Interoperability endpoints

  • Direct secure messaging: sgreathouse301006@reidhealth.direct-ci.com

Organizations & group practices 2

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 1

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": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1578720702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-962-4872",
            "fax_number": "765-935-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 CHESTER BLVD",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741212",
            "telephone_number": "765-962-4872",
            "fax_number": "765-935-8913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREATHOUSE",
        "first_name": "SHAWN",
        "middle_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-16",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IN",
            "license": "01073741A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000951920",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201241270",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgreathouse301006@ReidHealth.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Reid Physician Associates, Inc.",
            "address_1": "1911 Chester Blvd",
            "city": "Richmond",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473741212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

Verify at the official NPI Registry.