Sandra Kaye Shuburg, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

1086776 Issued in KY

Practice address

4922 Poplar Level Rd
Louisville, KY 40219-1128

Phone

(502) 434-5566

NPI assigned

Jan 30, 2023

Sex

Female

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 1

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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.

• Baymark Health Services of Kentucky, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Louisville, KY
  • NPI 1427639608
  NPD

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1972219228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4922 POPLAR LEVEL RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402191128",
            "telephone_number": "502-434-5566",
            "fax_number": "502-434-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4922 POPLAR LEVEL RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402191128",
            "telephone_number": "502-434-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUBURG",
        "first_name": "SANDRA",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1086776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE",
            "identifier": "1086776",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SShuburg@medmark.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4922 Poplar Level Rd",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402191128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "sshuburg@medmark.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4922 Poplar Level Rd",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402191128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SShuburg@medmark.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4922 Poplar Level Rd",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402191128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mary Haley Shrewsbury
• Shri Siddi Vinayaka Drugs Inc
• Brooke Christian Shriner, PHD
• Pavni Shrivastava
• Marcia Lynne Shrock, APRN
• Leeta G. Shuecraft, LCSW
• Alison Faythe Shuff Boswell, DO
• William Thomas Shuffett
• Cheryl Shuffitt, MSN APRN ACNPC-AG
• Shugoll & Sadlo Cardiology PLLC

• Registered Nurse in Louisville, KY
• Providers in Louisville, KY by specialty
• Registered Nurse in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.