Michael Shawn Lively, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

M3632 Issued in TX

Practice address

710 Water St
Kerrville, TX 78028-5329

Phone

(830) 258-7747

NPI assigned

May 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Legacy Urgent Care, PA

  • Urgent Care Clinic/Center
  • Frisco, TX
  • NPI 1568622272
  Medicare reassignment NPD
• Premier Physicians-II, P.a.

  dba Premier Urgent Care Plus

  • Urgent Care Clinic/Center
  • Woodway, TX
  • NPI 1801204656
  Medicare reassignment NPD
• Third Coast Emergency Physicians Sid Peterson PA

  • Emergency Medicine Physician
  • Kerrville, TX
  • NPI 1972541423
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1962460303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 FOOTHILLS DR",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780283873",
            "telephone_number": "717-246-9097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 WATER ST",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285329",
            "telephone_number": "830-258-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVELY",
        "first_name": "MICHAEL",
        "middle_name": "SHAWN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "M3632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8M6794",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "180018702",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180018701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lighthouse ABA LLC
• Cynthia Jeanette Lindeman, LPC
• Ivy Yap Lindo, RN
• Linette B. Melcher, MD PA
• Lisa Rouse, M.D., P.a.
• Arturo R Llanos, M.D.
• Paul Andrew Lobaina, RN
• Maria Theresa Locher, LMSW
• Jeannette C Long, APNP
• Nicole Longoria, COTA

• Emergency Medicine Physician in Kerrville, TX
• Providers in Kerrville, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.