DR. SHANE DAVID SMITH (NPI# 1124476676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124476676 |
| Entity Type | Individual |
| Full Name | DR. SHANE DAVID SMITH |
| Credential | M.D |
| Practice Address |
2301 Holmes St Kansas City MO 64108 |
| Mailing Address |
2301 Holmes St Dept of Pathology Kansas City MO 64108-2640 |
| Practice Telephone | 8164044175 |
| Practice Fax Number | 8164040003 |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2018-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | 2017017409 | MO | Allopathic & Osteopathic Physicians |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801363288 | Shane Smith | Counselor | 10401 Shaw St, Oakland, CA 94605-5116 | 2018-10-24 |
| 1609306158 | Shane Eric Smith | Chiropractor | 1300 E 66th St Ste 100, Richfield, MN 55423-2685 | 2017-06-18 |
| 1396199733 | Shane Todd Smith | Registered Nurse | 725 Rothrock Dr, Galloway, OH 43119-8692 | 2016-04-22 |
| 1679815484 | Shane Timothy Smith | Counselor | 4629 Celia Way, Apt 202, Bellingham, WA 98226-7475 | 2013-03-19 |
| 1972726719 | Shane Smith | Chiropractor | 1380 Long Fellow Ave, Chico, CA 95926 | 2007-04-10 |
| 1821177197 | Shane Smith | Chiropractor | 2301 Berlin Tpke, Newington, CT 06111-3206 | 2006-11-06 |
| 1184705980 | Shane Michael Smith | Family Medicine | 516 W 14th Ave Ste 100, Holdrege, NE 68949-1215 | 2006-10-18 |
| 1003465675 | Shane R Smith | Social Worker | 403 Stony Landing Rd, Moncks Corner, SC 29461-3967 | 2019-09-06 |
| 1255859567 | Shane Mcbride Smith | Physician Assistant | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2017-09-07 |
| 1124578836 | Shane Smith | Chiropractor | 12313 Gold St, Omaha, NE 68144-2760 | 2016-10-05 |
| Street Address |
2301 HOLMES ST |
| City | KANSAS CITY |
| State | MO |
| Zip Code | 64108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063416949 | Heather K Isom | Emergency Medicine | 2301 Holmes St, Kansas City, MO 64108-2640 | 2005-06-09 |
| 1457951733 | Edin Mehmedovic | Pharmacist | 2301 Holmes St, Kansas City, MO 64108-2677 | 2020-10-27 |
| 1679170005 | Melissa Kay Abramovitz | Nurse Practitioner | 2301 Holmes St, Kansas City, MO 64108-2640 | 2020-10-08 |
| 1487269957 | Collin Curry | Nurse Practitioner | 2301 Holmes St, Kansas City, MO 64108-2640 | 2020-09-11 |
| 1114530631 | Eric Potrykus | Pharmacist | 2301 Holmes St, Kansas City, MO 64108-2640 | 2020-08-25 |
| 1093323784 | Katie Lynn Luetkenhaus | Pharmacist | 2301 Holmes St, Kansas City, MO 64108-2640 | 2020-07-19 |
| 1063020907 | Jordan Elaine Frangello | Pharmacist | 2301 Holmes St, Kansas City, MO 64108-2640 | 2020-07-16 |
| 1114545357 | Aaron Lawson | Pharmacist | 2301 Holmes St, Kansas City, MO 64108-2640 | 2020-07-13 |
| 1336766013 | Gadison Quick | Pharmacist | 2301 Holmes St, Kansas City, MO 64108-2640 | 2020-06-29 |
| 1376166843 | Rebecca Ann Garton | Pharmacist | 2301 Holmes St, Kansas City, MO 64108-2640 | 2020-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194345561 | Diversity Telehealth, LLC | Health Educator | 1601 East 18th Street, 320a, Kansas City, MO 64108 | 2020-04-25 |
| 1447894092 | Claire-louise Sophia Young | Student in an Organized Health Care Education/Training Program | Truman Medical Center - Department of Pathology, 2301 Holmes, Kansas City, MO 64108 | 2019-11-06 |
| 1053962415 | Kymberly Kline | Behavior Technician | Riley Aba & Autism Center, 1936 Summit St, Kansas City, MO 64108 | 2019-09-26 |
| 1841854643 | Mallak Ahmed Ghozlan Zatreh | Student in an Organized Health Care Education/Training Program | 2301 Homes Street, Kansas City, MO 64108 | 2019-04-26 |
| 1003470881 | Sindhuja Palle | Internal Medicine | Truman Medial Center, 2301 Holmes Dept. of Interal Medicine, Kansas City, MO 64108 | 2019-04-26 |
| 1467016253 | Osama Mahmoud Okasha | Internal Medicine | Truman Medicial Center, 2301 Holmes, Dept of Internal Medicine, Kansas City, MO 64108 | 2019-04-26 |
| 1730643719 | Michele D Smith | Registered Nurse | 2101 Charlotte Street, Urology, Kansas City, MO 64108 | 2019-01-24 |
| 1437640414 | Omar Fayez Ahmad Abuqamar | Student in an Organized Health Care Education/Training Program | Truman Medical Center, 2301 Holmes St., Dept. of Internal Medicine, Kansas City, MO 64108 | 2018-05-24 |
| 1992200190 | Hannah Rebekah Hurst | Student in an Organized Health Care Education/Training Program | 2101 Charlotte St Ste 200, Kansas City, MO 64108 | 2018-03-28 |
| 1659873404 | William Andrew Carroll | Chiropractor | 313 E. 17th St. #210, Kansas City, MO 64108 | 2018-03-07 |
| Find all providers in zip 64108 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750993093 | Alyssa Brown | Student in an Organized Health Care Education/Training Program | 1444 Grand Blvd Apt 1201, Kansas City, MO 64106-2975 | 2020-08-18 |
| 1093330599 | Tarek Haidar | Student in an Organized Health Care Education/Training Program | Research Medical Center / Goppert Family Medicine, 6675 Holmes Road, Ste 450, Kansas City, MO 64131 | 2020-06-10 |
| 1174142640 | John Price | Student in an Organized Health Care Education/Training Program | 12806 Lathrop Ave, Kansas City, KS 66109-1003 | 2020-04-14 |
| 1104454396 | Bryan Clements | Student in an Organized Health Care Education/Training Program | 3940 Genessee St, Kansas City, MO 64111-4105 | 2020-04-01 |
| 1699302729 | Molly Bliss | Student in an Organized Health Care Education/Training Program | 3901 Rainbow Blvd # Ms 4034, Kansas City, KS 66160-8500 | 2020-03-26 |
| 1205467578 | Tina Thanh Thuy Tran | Student in an Organized Health Care Education/Training Program | 5100 Grand Ave, Kansas City, MO 64112-2739 | 2020-01-27 |
| 1124659495 | Danni Gray | Student in an Organized Health Care Education/Training Program | 806 E 110th Ter, Kansas City, MO 64131-3543 | 2020-01-27 |
| 1841821113 | Shannon Rebecca Pulliam | Student in an Organized Health Care Education/Training Program | 3012 Charlotte St, Kansas City, MO 64109-1422 | 2020-01-27 |
| 1578194841 | Michael Peter Schooley | Student in an Organized Health Care Education/Training Program | 5414 N Mercier Ave, Kansas City, MO 64118-7821 | 2020-01-27 |
| 1023649399 | Jessica Hartzler | Student in an Organized Health Care Education/Training Program | 25 E 12th St Apt 1102, Kansas City, MO 64106-2342 | 2020-01-27 |
| Find all providers in KANSAS CITY | ||||
| City | KANSAS CITY |
| Zip Code | 64108 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.