Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SHANE MCDOUGAL MD
NPI 1104871862
Family Medicine in Whitesburg, KY

Q: What is Shane Mcdougal's NPI number?

The NPI number for Shane Mcdougal is 1104871862. It was assigned to this individual provider in the NPPES registry on May 23, 2006.

Q: What is Shane Mcdougal's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Shane Mcdougal was last updated on July 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 23, 2006PECOS Enrolled

97.4/100

CMS Quality Rating

214 HOSPITAL RD, WHITESBURG, KY 41858(606) 633-4414 Get Directions Write a Review

NPPES record last updated: July 31, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 31, 2026, Oct 17, 2018 (2 updates tracked since 2018).

On this page

About Shane Mcdougal Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANE MCDOUGAL MD (NPI 1104871862) is an individual family medicine provider in Whitesburg, Kentucky, licensed in Kentucky (37761) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Whitesburg Arh Hospital, and is a graduate of University Of Kentucky College Of Medicine (2000).

NPPES Registry Identity

NPI1104871862

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameSHANE MCDOUGALCredential: MD

Location Address214 HOSPITAL RDWhitesburg, KY 41858-7627

Mailing Address214 Hospital RdWhitesburg, KY 41858-7627 · (606) 633-4414

Phone(606) 633-4414

Sole ProprietorNo

Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 2000

Enumeration DateMay 23, 2006

Last NPPES UpdateJuly 31, 20262 updates tracked since enumeration

NPPES CertifiedJuly 31, 2026

✔ NPI 1104871862 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in KY · 37761

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

214 HOSPITAL RD, Whitesburg, KY 41858

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Other Identifiers 1

Medicaid64063126KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shane Mcdougal Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6709854151

PECOS Enrollment IDI20130925000126

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Whitesburg Arh Hospital

Acute Care Hospitals · Whitesburg, KY

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number180002

Location240 Hospital RoadWhitesburg, KY 41858 · Letcher County

Emergency services Birthing friendly

Pikeville Medical Center

Acute Care Hospitals · Pikeville, KY

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180044

Location911 Bypass RoadPikeville, KY 41501 · Pike County

Emergency services Birthing friendly

Harlan Arh Hospital

Acute Care Hospitals · Harlan, KY

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number180050

Location81 Ball Park RoadHarlan, KY 40831 · Harlan County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41858 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.4/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

76.55

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers21 claims36 services$4.17 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

3 suppliers18 claims28 services$41.60 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

3 suppliers11 claims11 services$21.53 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

3 suppliers14 claims14 services$20.71 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

4 suppliers19 claims43 services$3.00 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers53 claims53 services$20.08 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KEVIN MATTHEW GOOCH MD

Internal Medicine

214 HOSPITAL RD
WHITESBURG, KY 41858

Letcher County (606) 633-3631

WHITESBURG WOMEN'S CENTER, LLC

Obstetrics & Gynecology

214 HOSPITAL RD, SUITE D
WHITESBURG, KY 41858

Letcher County (606) 633-5553

JOHN L. PELLEGRINI M.D.

Surgery

214 HOSPITAL RD, SUITE 1
WHITESBURG, KY 41858

Letcher County (606) 633-2255

APPALACHIAN REGIONAL HEALTHCARE, INC.

Clinic/Center (Multi-Specialty)

214 HOSPITAL RD
WHITESBURG, KY 41858

Letcher County (606) 633-3631

AMYE E THOMAS

Nurse Practitioner (Family)

214 HOSPITAL RD
WHITESBURG, KY 41858

Letcher County (606) 633-4414

APPALACHIAN REGIONAL HEALTHCARE, INC.

Clinic/Center (Rural Health)

214 HOSPITAL RD
WHITESBURG, KY 41858

Letcher County (606) 633-3631

SAMANTHA OCTAVIA EVERSOLE DO

Internal Medicine

214 HOSPITAL RD
WHITESBURG, KY 41858

Letcher County (606) 633-4414

TIN CHANH TRAN M.D.

Surgery

214 HOSPITAL RD, SUITE A
WHITESBURG, KY 41858

Letcher County (606) 633-2255

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Mcdougal's NPI number?

The NPI number for Shane Mcdougal is 1104871862. It was assigned to this individual provider in the NPPES registry on May 23, 2006.

Where is Shane Mcdougal located?

Shane Mcdougal practices at 214 Hospital Rd, Whitesburg, KY 41858. The listed phone number is (606) 633-4414.

What is Shane Mcdougal's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Shane Mcdougal enrolled in Medicare?

Yes. Shane Mcdougal is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shane Mcdougal accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and AvMed list Shane Mcdougal as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Shane Mcdougal affiliated with any hospitals?

According to CMS data, Shane Mcdougal is affiliated with Whitesburg Arh Hospital, Pikeville Medical Center and Harlan Arh Hospital.

When was this NPI record last updated?

The NPPES record for Shane Mcdougal was last updated on July 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.