NPIMap

Organization Active NPI

First Urology, PSC

  • Urology Physician
  • Jeffersonville, IN
National Provider Identifier
1922099811
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
FIRST UROLOGY, PSC
Practice address
101 Hospital Blvd
Jeffersonville, IN 47130-3769
Phone
(812) 282-3899
Fax
(812) 282-4172
NPI assigned
Oct 31, 2005
Last updated
Jul 1, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
FIRST UROLOGY,PSCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Authorized official

Name
Micheal Shannon
Title
Ceo
Phone
(812) 282-3899

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
Radiation Oncology Physician 2085R0001X
Diagnostic Radiology Physician 2085R0202X
Vascular & Interventional Radiology Physician 2085R0204X
Urology Physician 208800000X Primary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Acute Care Nurse Practitioner 363LA2100X
Adult Health Nurse Practitioner 363LA2200X
Family Nurse Practitioner 363LF0000X

Addresses

Primary practice location

101 Hospital Blvd
Jeffersonville, IN 47130-3769

Mailing address

101 Hospital Blvd
Jeffersonville, IN 47130-3769
Phone (812) 282-3899

Other identifiers 5

IdentifierTypeStateIssuer
100075260MedicaidIN
65906414MedicaidKY
78902830MedicaidKY
CF7705OtherKYRR MEDICARE
CG9483OtherINRR MEDCIARE

Other names 1

  • dba Southern Indiana RadiationTherapy Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN, DE, CT4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20040512000212 KY Part B Supplier - Clinic/Group Practice 3779572888 Receives reassigned benefits from 63 practitioners
Practice locations: Louisville, KY; Shepherdsville, KY; Shelbyville, KY; Mt Washington, KY; La Grange, KY; Carrolton, KY
O20040602000501 IN Part B Supplier - Clinic/Group Practice 3779572888 Receives reassigned benefits from 63 practitioners
Practice locations: Corydon, IN; Jeffersonville, IN; New Albany, IN; Scottsburg, IN
O20251117000008 DE Part B Supplier - Clinic/Group Practice 3779572888 Receives reassigned benefits from 1 practitioner
Practice locations: Wilmington, DE
O20260625000068 CT Part B Supplier - Clinic/Group Practice 3779572888 Receives reassigned benefits from 1 practitioner
Practice locations: Ridgefield, CT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0320411First Urology PSC101 Hospital Blvd, Jeffersonville, IN 47130Certificate of waiverJul 29, 2028
15D1097001First Urology, PSC101 Hospital Blvd, Jeffersonville, IN 47130AccreditationMay 27, 2028

National Provider Directory

National Provider Directory
Part of
First Urology PSC

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

3431 Solutions Ctr
Chicago, IL 60677

313 Federal Dr NW
Ste 140
Corydon, IN 47112

1322 Spring St
Jeffersonvlle, IN 47130
Phone (812) 285-6000

1407 Spring St
Ste 3
Jeffersonvlle, IN 47130

207 Sparks Ave
Ste 404
Jeffersonvlle, IN 47130
Phone (812) 218-3212

1919 State St
Ste 200
New Albany, IN 47150
Phone (502) 897-5139

1023 New Moody Ln
Ste 202A
Lagrange, KY 40031
Phone (502) 222-3324

100 E Market St
Louisville, KY 40202
Phone (502) 579-8253

3 Audubon Plaza Dr
Ste 340
Louisville, KY 40217
Phone (502) 634-6767

3900 S DuPont Sq
Ste C
Louisville, KY 40207

3920 S DuPont Sq
#B
Louisville, KY 40207

3991 Dutchmans Ln
Ste 402
Louisville, KY 40207
Phone (502) 899-6846

4130 Dutchmans Ln
#2B
Louisville, KY 40207
Phone (502) 899-6846

4130 Dutchmans Ln
Bldg 2
Louisville, KY 40207
Phone (502) 899-6846

4130 Dutchmans Ln
Bldg 2B
Louisville, KY 40207
Phone (502) 899-6846

4500 Churchman Ave
Ste 304
Louisville, KY 40215
Phone (502) 367-7363

5129 Dixie Hwy
Ste 307
Louisville, KY 40216
Phone (502) 447-4595

5210 Dixie Hwy
Ste 105
Louisville, KY 40216

1100 Walnut St
#206
Owensboro, KY 42301
Phone (270) 713-0177

1903 W Hebron Ln
Ste 205
Shepherdsville, KY 40165

Practitioners & affiliated clinicians

Practitioners 84

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 84

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782864000000",
    "number": "1922099811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL BLVD",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303769",
            "telephone_number": "812-282-3899",
            "fax_number": "812-282-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL BLVD",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303769",
            "telephone_number": "812-282-3899",
            "fax_number": "812-282-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST UROLOGY, PSC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIRST UROLOGY,PSC",
        "enumeration_date": "2005-10-31",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "MICHEAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-282-3899"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100075260",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65906414",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78902830",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CF7705",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDCIARE",
            "identifier": "CG9483",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Southern Indiana RadiationTherapy Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jeffersonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.