Individual provider Active NPI

Richard Patrick Shaughnessy IV, DO

  • Gastroenterology Physician
  • Phoenix, AZ
National Provider Identifier
1689776254
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
3911 Issued in AZ
Practice address
1300 N 12TH St
Suite 603
Phoenix, AZ 85006-2848
Phone
(602) 254-6686
Fax
(602) 254-4258
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 3911 AZ Primary

Addresses

Primary practice location

1300 N 12TH St
Suite 603
Phoenix, AZ 85006-2848

Mailing address

3020 E Camelback Rd Ste 301
Phoenix, AZ 85016-4418
Phone (602) 264-9100

Other practice location 1

4951 S White Mountain Rd Bldg A
Show Low, AZ 85901-7827
Phone (928) 537-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040331000611 AZ Practitioner - GastroenterologyPractitioner - Internal Medicine 6305838384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
College of Osteo Med of the Pacific at Pomona, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Healthcare Medical AssociatesGroup PAC ID 8729205737, 74 clinicians

Practice addresses (Care Compare)

4951 S White Mountain Rd
BLDG a
Show Low, AZ 85901-7801
Phone (928) 537-6700

Hospital & facility affiliations

  • Summit Healthcare Regional Medical Center Hospital, Show Low, AZ, CCN 030062

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy62
Upper gastrointestinal (GI) endoscopy for acid reflux61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3911AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Healthcare Medical Associates Internal Medicine CurrentSince May 28, 2024 Accepting new patients
Summit Healthcare Association Current Accepting new patients
Summit Healthcare Medical Associates CurrentSince May 28, 2024 Accepting new patients
Honorhealth Ambulatory Gastroenterology Past Accepting new patients
Summit Healthcare Association Past Accepting new patients

Locations

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

4951 S White Mountain Rd
Bldg A
Show Low, AZ 85901
Phone (928) 537-6700

Interoperability endpoints

  • Direct secure messaging: richardshaughnessy@shrmcshma.allscriptsdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1689776254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 E CAMELBACK RD STE 301",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164418",
            "telephone_number": "602-264-9100",
            "fax_number": "602-264-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST",
            "address_2": "SUITE 603",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062848",
            "telephone_number": "602-254-6686",
            "fax_number": "602-254-4258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4951 S White Mountain Rd Bldg A",
            "address_purpose": "LOCATION",
            "city": "Show Low",
            "state": "AZ",
            "postal_code": "859017827",
            "country_code": "US",
            "telephone_number": "928-537-6700",
            "fax_number": "928-532-2138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAUGHNESSY",
        "first_name": "RICHARD",
        "middle_name": "PATRICK",
        "name_suffix": "IV",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "3911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.