Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Timothy R Shady, FNP-C

Individual provider Nurse Practitioner · NPI 1619406873

Timothy R Shady, FNP-C is a Nurse Practitioner in Sayre, Pennsylvania. Qualified in 2017, 9 years ago. Practices with Guthrie Medical Group PC, a 797-clinician group and accepts Medicare assignment. Licensed in New York and Pennsylvania.

Years since qualifying
9
Licensed in
NY, PA
In the registry since
2017
Specialties on file
2
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

1 Guthrie Sq
Sayre, PA 18840-1625
Phone: (570) 887-2383
Fax: (570) 887-3285
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence SP018240 (PA)
Family Medicine Physician Taxonomy 207Q00000X · Licence F342441-1 (NY)

Record details

NPI number1619406873
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedJune 9, 2017
Last updated in NPPESMarch 8, 2021
Certification dateMarch 8, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Guthrie Medical Group Pc — 797 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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