Active NPI
Matthew Shea, DO
- Nephrology Physician
- Somerset, KY
National Provider Identifier
1700270949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 04163
- Practice address
- 104 Hardin LN Ste a
Somerset, KY 42503-3800 - Phone
- (606) 678-2063
- NPI assigned
- Mar 25, 2015
- Last updated
- Jun 2, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 04163 | KY | |
| Nephrology Physician | 207RN0300X | 04163 | KY | Primary |
Addresses
Primary practice location
104 Hardin LN Ste a
Somerset, KY 42503-3800
Mailing address
104 Hardin LN Ste a
Somerset, KY 42503-3800
Phone (606) 678-2063
Other practice location 1
350 Hospital Way Ste 101
Somerset, KY 42503-2872
Phone (606) 451-5093
Other practice location 2
University of Kentucky
800 Rose Street
Lexington, KY 40536
Phone (859) 323-2636
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Somerset | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Pikeville, Kentucky College of Osteopathic Med, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
104 Hardin Lane
Suite a
Somerset, KY 42503-3800
104 Hardin LN
Suite a
Somerset, KY 42503-3800
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04163 | KY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cumberland Nephrology | Nephrology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Nephrology Physician
- Somerset, KY
- NPI 1063404481
-
- Nephrology Physician
- Somerset, KY
- NPI 1093850091
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Fresenius Kidney Care Wayne County
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Monticello, KY
- NPI 1770939241
Dialysis facility
-
dba Lake Cumberland Regional Hospital
- Rural Acute Care Hospital
- Somerset, KY
- NPI 1619038247
-
- Critical Access Hospital
- Russell Springs, KY
- NPI 1013954437
-
- Critical Access Hospital
- Monticello, KY
- NPI 1871548016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654128000000",
"number": "1700270949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 HARDIN LN STE A",
"city": "SOMERSET",
"state": "KY",
"postal_code": "425033800",
"telephone_number": "606-678-2063",
"fax_number": "606-678-2218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 HARDIN LN STE A",
"city": "SOMERSET",
"state": "KY",
"postal_code": "425033800",
"telephone_number": "606-678-2063"
}
],
"practiceLocations": [
{
"address_1": "350 Hospital Way Ste 101",
"address_purpose": "LOCATION",
"city": "Somerset",
"state": "KY",
"postal_code": "425032872",
"country_code": "US",
"telephone_number": "606-451-5093",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "University of Kentucky",
"address_2": "800 Rose Street",
"address_purpose": "LOCATION",
"city": "Lexington",
"state": "KY",
"postal_code": "40536",
"country_code": "US",
"telephone_number": "859-323-2636",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHEA",
"first_name": "MATTHEW",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-25",
"last_updated": "2022-06-02",
"certification_date": "2022-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "KY",
"license": "04163",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "KY",
"license": "04163",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Somerset",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "104 Hardin Ln Ste A",
"city": "Somerset",
"state": "KY",
"country_code": "US",
"postal_code": "425033800",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Somerset, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; 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.