Individual provider Active NPI

Michael C Shockley, MD

  • Obstetrics & Gynecology Physician
  • Parkersburg, WV
National Provider Identifier
1891792651
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
17290 Issued in WV
Practice address
705 Garfield Ave
Suite 400
Parkersburg, WV 26101-5444
Phone
(304) 485-4700
Fax
(304) 485-4466
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 17290 WV
Gynecology Physician 207VG0400X 35065899 OH
Obstetrics Physician 207VX0000X 35065899 OH
Obstetrics & Gynecology Physician 207V00000X 17290 WV Primary

Addresses

Primary practice location

705 Garfield Ave
Suite 400
Parkersburg, WV 26101-5444

Mailing address

705 Garfield Ave
Suite 400
Parkersburg, WV 26101-5444
Phone (304) 485-4700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mshockley108792@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20050121000206 WV Practitioner - Obstetrics/Gynecology 1951379080

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35065899OHMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Camden Clark Memorial Hospital Corporation 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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1891792651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 GARFIELD AVE",
            "address_2": "SUITE 400",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015444",
            "telephone_number": "304-485-4700",
            "fax_number": "304-485-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 GARFIELD AVE",
            "address_2": "SUITE 400",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015444",
            "telephone_number": "304-485-4700",
            "fax_number": "304-485-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCKLEY",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "WV",
            "license": "17290",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "OH",
            "license": "35065899",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "OH",
            "license": "35065899",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WV",
            "license": "17290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mshockley108792@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "705 Garfield Ave",
            "city": "Parkersburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261015444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

Verify at the official NPI Registry.