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

Last updated

Mar 23, 2010By the provider in NPPES

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, MDNPI 1134109135

Title

Owner

Phone

(270) 338-9653

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• William Edward Shuttleworth, MD

  • Surgery Physician
  • Powderly, KY
  • NPI 1134109135
  Authorized official Same address or phone

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": "",
            "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

• Surgery Physician in Powderly, KY
• Providers in Powderly, KY by specialty
• 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.