Marissa Eusebio Shih, A.P.R.N.

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3003180 Issued in KY

Practice address

115 Rockwood LN
Hazard, KY 41701-9415

Phone

(606) 436-5761

Fax

(606) 436-5797

NPI assigned

Oct 6, 2006

Last updated

Sep 19, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Kentucky River Community Care, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hazard, KY
  • NPI 1528017142

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Alc Resources LLC

  dba Central Kentucky Behavioral Health

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Lexington, KY
  • NPI 1386687192

  Family

  NPD (past)
• Ashland Psychiatry Associates, PSC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ashland, KY
  • NPI 1255361176
  NPD (past)
• Horizon Healthcare Center LLC

  dba Paragon Family Practice

  • Nurse Practitioner
  • Lexington, KY
  • NPI 1932149622
  NPD (past)
• Lexington Primary Care LLC

  • Family Medicine Physician
  • Lexington, KY
  • NPI 1194741017
  NPD (past)
• Unified Psychiatry, PSC

  • Psychiatry Physician
  • Ashland, KY
  • NPI 1588769798
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1629165956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ROCKWOOD LN",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019415",
            "telephone_number": "606-436-5761",
            "fax_number": "606-436-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ROCKWOOD LN",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019415",
            "telephone_number": "606-436-5761",
            "fax_number": "606-436-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIH",
        "first_name": "MARISSA",
        "middle_name": "EUSEBIO",
        "name_prefix": "Mrs.",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3180P",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3003180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATION TAX ID",
            "identifier": "61-0991301",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78004215",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathy Shepherd
• Marion L Shepherd, APRN
• Robert Jordan Shepherd, APRN, FNP-C
• Sheridan Radiology Services of Central FL, Inc.
• Kaitlyn E Shields, CRNA
• Michael A Shilot, CRNA
• James H Shoptaw, M.D.
• Angel Short
• Brain G Short
• Jo'E L. Short

• Psychiatric/Mental Health Nurse Practitioner in Hazard, KY
• Providers in Hazard, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.