Active NPI
Nora K Shumway, MD
- Dermatology Physician
- Saint Peters, MO
National Provider Identifier
1982968103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 2016011558
- Practice address
- 201BJC St. Peters Dr
Suite 1a
Saint Peters, MO 63376-3385 - Phone
- (636) 277-0073
- Fax
- (636) 277-0074
- NPI assigned
- Jul 2, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 2016011558 | MO | Primary |
Addresses
Primary practice location
201BJC St. Peters Dr
Suite 1a
Saint Peters, MO 63376-3385
Mailing address
801 York St
Manitowoc, WI 54220-4630
Phone (866) 630-9882
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016011558 | MO | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479772800000",
"number": "1982968103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 YORK ST",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542204630",
"telephone_number": "866-630-9882",
"fax_number": "920-682-5810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201BJC ST. PETERS DR",
"address_2": "SUITE 1A",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633763385",
"telephone_number": "636-277-0073",
"fax_number": "636-277-0074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUMWAY",
"first_name": "NORA",
"middle_name": "K",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-02",
"last_updated": "2016-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MO",
"license": "2016011558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Peters, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.