W. Edward Shuttleworth PSC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

W. EDWARD SHUTTLEWORTH PSC

Practice address

1008 Medical Center Dr Ste a
Powderly, KY 42367-5463

Phone

(270) 338-9653

Fax

(270) 338-9656

NPI assigned

Mar 23, 2010

Organization subpart

No

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

Authorized official

Name

Dr. William Edward Shuttleworth, MD

Title

Owner

Phone

(270) 338-9653

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269302400000",
    "number": "1982928701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 MEDICAL CENTER DR STE A",
            "city": "POWDERLY",
            "state": "KY",
            "postal_code": "423675463",
            "telephone_number": "270-338-9653",
            "fax_number": "270-338-9656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 MEDICAL CENTER DR STE A",
            "city": "POWDERLY",
            "state": "KY",
            "postal_code": "423675463",
            "telephone_number": "270-338-9653",
            "fax_number": "270-338-9656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W. EDWARD SHUTTLEWORTH PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-23",
        "last_updated": "2010-03-23",
        "status": "A",
        "authorized_official_last_name": "SHUTTLEWORTH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-338-9653",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64178551",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kylee Stroud
• Mark A. Tackett, M.D.
• John Ashley Thompson, D.M.D
• Eli Travis, MD
• Hilary A. Vandiver, APRN
• Sandi Walker
• Crystal Lynn Ward, APRN
• George Stephen Wood, O D

• All providers in Powderly, KY
• Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; 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.