Provider Demographics
NPI:1275757858
Name:KAY M. SHILLING M.D.P.C.
Entity Type:Organization
Organization Name:KAY M. SHILLING M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHILLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-393-4355
Mailing Address - Street 1:7602 PACIFIC ST
Mailing Address - Street 2:#302
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-5405
Mailing Address - Country:US
Mailing Address - Phone:402-393-4355
Mailing Address - Fax:401-393-4356
Practice Address - Street 1:7602 PACIFIC ST
Practice Address - Street 2:#302
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-5405
Practice Address - Country:US
Practice Address - Phone:402-393-4355
Practice Address - Fax:401-393-4356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE159382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========68114A001OtherTRICARE
NE=========100Medicaid
NE=========68114A001OtherTRICARE
NE095748Medicare ID - Type UnspecifiedMEDICARE