Kathy Shum Ellington, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

V1617 Issued in TX

Practice address

2017 Rickety LN
Tyler, TX 75703-1706

Phone

(903) 533-8811

Fax

(903) 593-5511

NPI assigned

Apr 28, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kathy Shum Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Obstetrics/Gynecology

Education

University of North Texas HSC, College of Osteopathic Med, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kathy.shumellington@smllc.eclinicaldirectplus.com
• Direct secure messaging: kshum102125@direct.phhs.org

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.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment
• Methodist Hospitals of Dallas

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1528027786
  NPD (past)
• Stella Mattina Primary Care Inc

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1396568713
  NPD (past)

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1891316147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 RICKETY LN",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031706",
            "telephone_number": "903-533-8811",
            "fax_number": "903-593-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 RICKETY LN",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031706",
            "telephone_number": "903-533-8811",
            "fax_number": "903-593-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUM ELLINGTON",
        "first_name": "KATHY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-28",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "V1617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "SHUM",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Colleen Megan Shulenberger, CPM, LM
• Shultz Family Dentistry PLLC
• Belinda Ann Shultz, NP
• Jared Scott Shultz, DDS
• Misty Michelle Shultz, LPC
• Rachel C Shumate, DPT
• Wesley Shumate, PT
• Preston Wayne Shumway, DO
• Emily Jane Shupe, AUD, CCC/A
• Jennifer Marsh Shupe, MD

• Obstetrics & Gynecology Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.

Verify at the official NPI Registry.