Kenneth A Shaver, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01033608A Issued in IN

Practice address

1601 Medical Arts Blvd
Suite 100
Anderson, IN 46011-3459

Phone

(765) 298-5700

Fax

(765) 298-4913

NPI assigned

Jul 24, 2006

Last updated

Feb 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: mshaver7930@ecommunitydirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Home Health Services, Inc

  • Durable Medical Equipment & Medical Supplies
  • Anderson, IN
  • NPI 1619575024
  NPD (past)
• Community Hospitals of Indiana Inc

  dba Summitville Medical Arts

  • Family Medicine Physician
  • Summitville, IN
  • NPI 1235157140
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1629090949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 W 200 N",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460119146",
            "telephone_number": "765-298-5706",
            "fax_number": "765-298-4913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 MEDICAL ARTS BLVD",
            "address_2": "SUITE 100",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460113459",
            "telephone_number": "765-298-5700",
            "fax_number": "765-298-4913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAVER",
        "first_name": "KENNETH",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01033608A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000313020",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100172010",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mshaver7930@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "1601 Medical Arts Blvd",
            "address_2": "Suite 100",
            "city": "Anderson",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460113459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karen A Seybert, RN
• Bahadur Shah, MD
• Sana Mohd Javid Shaikh, DDS
• David A Shapiro, MD
• Ubaidullah Sharief, MD
• Samuel G Shaver, MD
• Adrienne Shaw, M.A, BCBA
• Heather P Sheets, LNP
• Kristen Sheilds
• Garland Shelton, PT

• Family Medicine Physician in Anderson, IN
• Providers in Anderson, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.