CHARLES B SHANE (NPI# 1386617298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1386617298 |
Entity Type | Individual |
Full Name | CHARLES B SHANE |
Credential | M.D. |
Practice Address |
205 Sycamore Hills Ct Louisville KY 40245-5095 |
Practice Telephone | 5022438330 |
Practice Fax Number | 5022438330 |
Mailing Telephone | 5022438330 |
Mailing Fax Number | 5022438330 |
Enumeration Date | 2006-02-10 |
Last Update Date | 2009-06-18 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
18903 | KY | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
KY | 64189038 | 05 | |
KY | ANTHEM | 000000068700 | 01 |
Street Address |
205 SYCAMORE HILLS CT |
City | LOUISVILLE |
State | KY |
Zip Code | 40245-5095 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083247753 | Stepping Stones Pediatric Therapy, LLC | Early Intervention Provider Agency | 330 Cranbury Way, Louisville, KY 40245 | 2020-02-20 |
1790324333 | Joseph Strano | Pharmacist | 12450 Lagrange Road, Louisville, KY 40245 | 2019-12-30 |
1174160725 | Anne S Hill | Technician | 16621 Taunton Vale Rd, Louisville, KY 40245 | 2019-12-03 |
1750808937 | Amy Judy | Assistant Behavior Analyst | 4512 Meadowlark Manor Dr, Louisville, KY 40245 | 2017-08-28 |
1104356567 | Mmr Cardiovascular Consulting LLC | Internal Medicine | 1101 Glenlake Way, Louisville, KY 40245 | 2017-06-18 |
1952830135 | Staci Marie Trofimov | Dietitian, Registered | 13008 Willow Forest Drive, Louisville, KY 40245 | 2017-06-09 |
1629524913 | Forefront Dermatology, S.c. | Dermatology | 159 S. English Station Road, Louisville, KY 40245 | 2016-08-28 |
1861867830 | Jamila Hadden | Counselor | 111 Parkview Dr., Louisville, KY 40245 | 2015-12-02 |
1538570312 | Brian Johnson | Case Manager/Care Coordinator | 4717 Middlesex Drive, 4717 Middlesex Drive, Louisville, KY 40245 | 2014-05-14 |
1033535828 | Genesis Eldercare Physician Services LLC | Nurse Practitioner | 16605 Chestnut Glen Pl, Louisville, KY 40245 | 2014-03-17 |
Find all providers in zip 40245 |
Taxonomy Code | 207VG0400X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Obstetrics & Gynecology |
Specialization | Gynecology |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902906092 | George M Kudmani | Obstetrics & Gynecology | 9822 3rd Street Rd, Suite 306, Louisville, KY 40272-2847 | 2006-09-25 |
1134147325 | Susan P Hertweck | Obstetrics & Gynecology | 3991 Dutchmans Ln Ste 303, Louisville, KY 40207-4723 | 2006-07-17 |
1124011556 | Karen H Reed | Obstetrics & Gynecology | 2355 Poplar Level Rd Ste 304, Louisville, KY 40217-1388 | 2005-08-31 |
1306287388 | Maggie L Dwiggins | Obstetrics & Gynecology | 3991 Dutchmans Ln Ste 303, Louisville, KY 40207 | 2013-07-08 |
1225303977 | George Kudmani Psc | Obstetrics & Gynecology | 9702 Stonestreet Rd, Suite 306, Louisville, KY 40272-6819 | 2012-03-14 |
1255657771 | Lousville Urogynecology Pllc | Obstetrics & Gynecology | 4121 Dutchmans Ln, Suite 401, Louisville, KY 40207-4707 | 2010-04-08 |
1861724072 | Donald B Katz Md LLC | Obstetrics & Gynecology | 4121 Dutchmans Ln, Suite 101, Louisville, KY 40207-4707 | 2010-02-12 |
1912160797 | Jessica A Shepherd | Obstetrics & Gynecology | 401 E Chestnut St, Suite 410, Louisville, KY 40202-5700 | 2008-07-02 |
1215067780 | Charles B Shane Md Psc | Obstetrics & Gynecology | 4001 Kresge Way, Suite 315, Louisville, KY 40207-4640 | 2007-03-06 |
1588717417 | Jeremy J Clark | Obstetrics & Gynecology | 401 E Chestnut St, Suite 410, Louisville, KY 40202-5700 | 2007-01-22 |
Find all providers in LOUISVILLE |
City | LOUISVILLE |
Zip Code | 40245 |
Please comment or provide details below to improve the information on CHARLES B SHANE.
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.