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Individual provider Active NPI

Jonathan Kale Gavin Shumate, MD

  • Obstetrics & Gynecology Physician
  • Newport, OR
National Provider Identifier
1740280072
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD154161 Issued in OR
Practice address
1010 SW Coast Hwy Ste 102
Newport, OR 97365-5239
Phone
(541) 265-4253
Fax
(541) 265-4035
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD.200122 LA
Obstetrics & Gynecology Physician 207V00000X MD00047503 WA
Obstetrics & Gynecology Physician 207V00000X MD154161 OR Primary

Addresses

Primary practice location

1010 SW Coast Hwy Ste 102
Newport, OR 97365-5239

Mailing address

1010 SW Coast Hwy Ste 102
Newport, OR 97365-5239
Phone (541) 265-4253

Other practice location 1

775 SW 9th St
Suite H
Newport, OR 97365-4895
Phone (541) 574-4767

Other identifiers 1

IdentifierTypeStateIssuer
500635045MedicaidOR

Other names 1

  • Dr. Jonathan Kale Gavin Shumate Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110803000704 OR Practitioner - Obstetrics/Gynecology 7517055577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York Medical College, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1010 SW Coast Hwy
Suite 102
Newport, OR 97365-5239
Phone (541) 265-4253

324 SW 7TH St
Suite B
Newport, OR 97365-4900
Phone (541) 265-4253

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.200122LAMDObstetrics & Gynecology Physician
MD00047503WAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrity Women's Health & Wellness, LLC Obstetrics & Gynecology CurrentSince Apr 24, 2020 Accepting new patients
Center for Womens Health at Evergreen Obstetrics & Gynecology Past Accepting new patients

Locations

324 SW 7th St
Ste B
Newport, OR 97365
Phone (541) 265-4253

1010 SW Coast Hwy
Ste 102
Newport, OR 97365
Phone (541) 265-4252

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 and National Provider Directory roles.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1740280072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 SW COAST HWY STE 102",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973655239",
            "telephone_number": "541-265-4253",
            "fax_number": "541-265-4035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SW COAST HWY STE 102",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973655239",
            "telephone_number": "541-265-4253",
            "fax_number": "541-265-4035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "775 SW 9th St",
            "address_2": "Suite H",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "OR",
            "postal_code": "973654895",
            "country_code": "US",
            "telephone_number": "541-574-4767",
            "fax_number": "541-574-4747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUMATE",
        "first_name": "JONATHAN",
        "middle_name": "KALE GAVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "LA",
            "license": "MD.200122",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD00047503",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD154161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500635045",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JONATHAN KALE",
            "last_name": "SHUMATE",
            "middle_name": "GAVIN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Newport, OR

Sources for this page

Verify at the official NPI Registry.