Michael Gene McIntosh, MD

Key facts

NPI

1609934777

Entity type

Individual (NPI type 1)

Primary specialty

Child & Adolescent Psychiatry Physician 2084P0804X

License

19408 (KY)

Practice address

1717 Dixie Hwy
Suite 200
Ft Wright, KY 41011

Phone

(839) 578-4143

Fax

(859) 344-3183

NPI assigned

Dec 4, 2006

Sex

Male

Sole proprietor

Yes

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.

• Arnold G. Shapiro MD, PLLC Psychiatry Physician · Ft Wright, KY · NPI 1881000545
  NPD (past)

Medicare Care Compare profile

Specialty

Psychiatry

Education

University of Toledo College of Medicine, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

Practice roles

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 25, 2019.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1609934777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 DIXIE HWY",
            "address_2": "SUITE 200",
            "city": "FT WRIGHT",
            "state": "KY",
            "postal_code": "41011",
            "telephone_number": "839-578-4143",
            "fax_number": "859-344-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 DIXIE HWY",
            "address_2": "SUITE 200",
            "city": "FT WRIGHT",
            "state": "KY",
            "postal_code": "41011",
            "telephone_number": "839-578-4143",
            "fax_number": "859-344-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "MICHAEL",
        "middle_name": "GENE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "KY",
            "license": "19408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64194087",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Ft Wright, KY · Child & Adolescent Psychiatry Physician in Kentucky