Shane Eric Hendon, D.O.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

03280 Issued in KY

Practice address

1532 Lone Oak Rd
Suite 310
Paducah, KY 42003-7913

Phone

(270) 443-0777

Fax

(270) 443-0999

NPI assigned

May 17, 2006

Last updated

Apr 21, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Gastroenterology

Education

University of Pikeville, Kentucky College of Osteopathic Med, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Missouri Hospital Physicians LLCGroup PAC ID 9133024334, 206 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110
• Mercy Hospital Stoddard Hospital, Dexter, MO, CCN 260160
• Mercy Hospital Perry Hospital, Perryville, MO, CCN 261311

Merit-based Incentive Payment System (MIPS)

Final score

67.6 of 100Reported as individual

Quality

80

Improvement activities

0

Cost

75.29

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southeast Missouri Hospital Physicians, LLC

  dba Mercy Clinic Southeast

  • Family Medicine Physician
  • Cape Girardeau, MO
  • NPI 1558311522

  Gastroenterology

  Medicare reassignment Care Compare group NPD
• Purchase Gastroenterology Associates PSC

  • Gastroenterology Physician
  • Mayfield, KY
  • NPI 1639131246
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Perry

  • Critical Access Hospital
  • Perryville, MO
  • NPI 1063117158
  Care Compare affiliation
• Southeast Health Center of Stoddard County, LLC

  dba Mercy Hospital Stoddard

  • General Acute Care Hospital
  • Dexter, MO
  • NPI 1801990825
  Care Compare affiliation
• Southeast Hospital

  dba Mercy Hospital Southeast

  • General Acute Care Hospital
  • Cape Girardeau, MO
  • NPI 1811006661
  Care Compare affiliation

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1992757975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636961",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636961",
            "telephone_number": "513-981-5130",
            "fax_number": "513-981-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 LONE OAK RD",
            "address_2": "SUITE 310",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037913",
            "telephone_number": "270-443-0777",
            "fax_number": "270-443-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDON",
        "first_name": "SHANE",
        "middle_name": "ERIC",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "DO927",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "03280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100129950",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Heller, LPN
• Abigail Reese Henderson
• Dalton T Henderson, APRN
• Debbie B Henderson, RPH.
• Kayla B Hendley, APRN
• Melissa A Hendrickson X
• Jennifer Henley
• Matthew Henry
• Cassidy Herndon
• Haley Herndon, PA-C

• Gastroenterology Physician in Paducah, KY
• Providers in Paducah, KY by specialty
• Gastroenterology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.