Provider Demographics
NPI:1578508271
Name:SHAY, KARA (MD)
Entity Type:Individual
Prefix:DR
First Name:KARA
Middle Name:
Last Name:SHAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-341-0288
Mailing Address - Fax:859-341-7482
Practice Address - Street 1:334 THOMAS MORE PKWY
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3464
Practice Address - Country:US
Practice Address - Phone:859-341-0288
Practice Address - Fax:859-341-7482
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38194174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000318170OtherANTHEM
KY64077613Medicaid
0409432OtherUNITED HEALTHCARE
IN200944740Medicaid
50006696OtherPASSPORT
7671542OtherAETNA
KYP00935632OtherRAILROAD MEDICARE
OH2466433Medicaid
310674100OtherUS DEPARTMENT OF LABOR
310674100OtherFEDERAL BLACK LUNG
KYP00935632OtherRAILROAD MEDICARE
310674100OtherFEDERAL BLACK LUNG
IN200944740Medicaid
KY3313281Medicare PIN
000000318170OtherANTHEM
310674100OtherUS DEPARTMENT OF LABOR
KY0399018Medicare PIN
KY00415004Medicare PIN