Basic Information
| Provider Information | |||||||||
| NPI: | 1578508271 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHAY | ||||||||
| FirstName: | KARA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 635283 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452635283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593410288 | ||||||||
| FaxNumber: | 8593417482 | ||||||||
| Practice Location | |||||||||
| Address1: | 334 THOMAS MORE PKWY | ||||||||
| Address2: | |||||||||
| City: | CRESTVIEW HILLS | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410173464 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593410288 | ||||||||
| FaxNumber: | 8593417482 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2006 | ||||||||
| LastUpdateDate: | 11/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 38194 | KY | N | Other Service Providers | Specialist | 207R00000X | 38194 | KY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000000318170 | 01 | ANTHEM | OTHER | 64077613 | 05 | KY | MEDICAID | 0409432 | 01 | UNITED HEALTHCARE | OTHER | 200944740 | 05 | IN | MEDICAID | 50006696 | 01 | PASSPORT | OTHER | 7671542 | 01 | AETNA | OTHER | P00935632 | 01 | KY | RAILROAD MEDICARE | OTHER | 2466433 | 05 | OH | MEDICAID | 310674100 | 01 | US DEPARTMENT OF LABOR | OTHER | 310674100 | 01 | FEDERAL BLACK LUNG | OTHER |