Nathan Charles Shumway, D.P.M.
Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Council Bluffs, IA
NPI 1629429451 · NPPES record last updated Jun 13, 2019
Key facts
- NPI
- 1629429451
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- PDT-559 (CO)
- Practice address
- 320 McKenzie Ave Ste 102
Council Bluffs, IA 51503 - Phone
- (712) 328-0297
- Fax
- (712) 328-2403
- NPI assigned
- Jun 22, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Clarinda Regional Health Center
Practice addresses (Care Compare)
100 Hospital Dr
Pender, NE 68047-4507
Phone (402) 385-3083
220 Essie Davison Dr
Clarinda, IA 51632-2915
Phone (712) 542-2176
Hospital & facility affiliations
- Clarinda Regional Health Center
- Pender Community Hospital
- George C Grape Community Hospital
- Memorial Community Hospital & Health System
Merit-based Incentive Payment System (MIPS)
- Final score
- 67.97 of 100
- Quality
- 34.29
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of nail tissue | 172 |
| Removal or shaving of skin growth | 19 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA, NE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190702002325 | IA | Practitioner - Podiatry | 3971837477 | Reassigns benefits to 4 organizations |
| I20241106001485 | NE | Practitioner - Podiatry | 3971837477 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 402 | NE | MD | Clinical Psychologist |
| PDT-559 | CO | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Community Hospital Corporation | Current |
Accepting new patients | |
| Clarinda Regional Health Center | Current | Accepting new patients | |
| Memorial Community Hospital Corporation | Current |
Accepting new patients | |
| Clarinda Regional Health Center | Current |
Accepting new patients | |
| Edward N Prikaszczikow | Past |
Accepting new patients |
Locations
220 Essie Davison Dr
Clarinda, IA 51632
Phone (712) 542-8330
2959 US Highway 275
Hamburg, IA 51640
Phone 71238215158070
2959 US Highway 275
#C
Hamburg, IA 51640
810 N 22nd St
Blair, NE 68008
Phone (402) 426-1116
812 N 22nd St
Blair, NE 68008
Phone (402) 426-4611
100 Hospital Dr
Pender, NE 68047
Phone (402) 385-3083
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | PDT-559 | CO | Yes |
Addresses
Primary practice location
320 McKenzie Ave Ste 102
Council Bluffs, IA 51503
Mailing address
320 McKenzie Ave Ste 102
Council Bluffs, IA 51503-1002
Phone (712) 328-0297
Other practice location 1
278 W Mutton Hollow Rd
Kaysville, UT 84037-1118
Phone (801) 717-0339
NPI Registry JSON
{
"created_epoch": "1466553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560384000000",
"number": "1629429451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 MCKENZIE AVE STE 102",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515031002",
"telephone_number": "712-328-0297",
"fax_number": "712-328-2403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 MCKENZIE AVE STE 102",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "51503",
"telephone_number": "712-328-0297",
"fax_number": "712-328-2403"
}
],
"practiceLocations": [
{
"address_1": "278 W Mutton Hollow Rd",
"address_purpose": "LOCATION",
"city": "Kaysville",
"state": "UT",
"postal_code": "840371118",
"country_code": "US",
"telephone_number": "801-717-0339",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHUMWAY",
"first_name": "NATHAN",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-22",
"last_updated": "2019-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "CO",
"license": "PDT-559",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Council Bluffs, IA
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- Casey Sicuso
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All providers in Council Bluffs, IA · Foot & Ankle Surgery Podiatrist in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.