Individual provider Active NPI

Charles R Shuman III, M.D.

  • Psychiatry Physician
  • Saint Joseph, MO
National Provider Identifier
1881617074
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
110236 Issued in MO
Practice address
105 Far West Dr Ste 202
Saint Joseph, MO 64506-3514
Phone
(816) 271-8113
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 110236 MO
Psychiatry Physician 2084P0800X 110236 MO Primary

Addresses

Primary practice location

105 Far West Dr Ste 202
Saint Joseph, MO 64506-3514

Mailing address

105 Far West Dr Ste 202
Saint Joseph, MO 64506-3514
Phone (816) 271-8113

Other practice location 1

5325 Faraon St
Saint Joseph, MO 64506-3488
Phone (816) 271-7273

Other practice location 2

5325 Faraon St
Saint Joseph, MO 64506-3488
Phone (816) 271-7273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
110236MOMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwestern Health Management, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1881617074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 FAR WEST DR STE 202",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063514",
            "telephone_number": "816-271-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 FAR WEST DR STE 202",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063514",
            "telephone_number": "816-271-8113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5325 Faraon St",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MO",
            "postal_code": "645063488",
            "country_code": "US",
            "telephone_number": "816-271-7273",
            "fax_number": "816-271-7376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5325 Faraon St",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MO",
            "postal_code": "645063488",
            "country_code": "US",
            "telephone_number": "816-271-7273",
            "fax_number": "816-271-7376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUMAN",
        "first_name": "CHARLES",
        "middle_name": "R",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MO",
            "license": "110236",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "110236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.