Timothy R Shady, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP018240 Issued in PA

Practice address

1 Guthrie SQ
Sayre, PA 18840-1625

Phone

(570) 887-2383

Fax

(570) 887-3285

NPI assigned

Jun 9, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Guthrie Medical Group PCGroup PAC ID 6002728656, shared by 5 NPIs, 795 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Robert Packer Hospital Hospital, Sayre, PA, CCN 390079

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tshady5687@direct-guthrie.org

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.

• Guthrie Medical Group, P.C.

  • Family Medicine Physician
  • Athens, PA
  • NPI 1962451153
  Medicare reassignment NPD
• Guthrie Medical Group, P.C.

  • Multi-Specialty Clinic/Center
  • Corning, NY
  • NPI 1134178635
  Medicare reassignment NPD
• Guthrie Medical Group, P.C.

  • General Practice Physician
  • Sayre, PA
  • NPI 1245246644

  Family Medicine

  NPD
• Guthrie Medical Group, P.C.

  • Family Medicine Physician
  • Sayre, PA
  • NPI 1508818733
  NPD
• Guthrie Medical Group PC

  • Clinical Medical Laboratory
  • Sayre, PA
  • NPI 1649225855
  NPD (past)

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

• Robert Packer Hospital

  • General Acute Care Hospital
  • Sayre, PA
  • NPI 1083614382
  Care Compare affiliation
• Robert Packer Hospital

  • General Acute Care Hospital
  • Towanda, PA
  • NPI 1134734528
  Care Compare affiliation

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1619406873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858",
            "fax_number": "570-887-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-887-2383",
            "fax_number": "570-887-3285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADY",
        "first_name": "TIMOTHY",
        "middle_name": "R",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-09",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP018240",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "F342441-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tshady5687@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1 Guthrie Sq",
            "city": "Sayre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "188401625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emalyn Marie Setzer, PT, DPT
• Kristen Sevilla
• Ashley Nicole Seymour
• Hend Shaaban
• Sohaib Khan Shabih, M.D
• Stanley M. Shafer, D.M.D.
• Aalesh Ashishbhai Shah
• Ashokkumar Ratanlal Shah, MD
• Bhavin S Shah, DDS
• Niral A Shah, MD

• Nurse Practitioner in Sayre, PA
• Providers in Sayre, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.