MICHAEL DIXON SHANE (NPI# 1154401990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154401990 |
| Entity Type | Individual |
| Full Name | MICHAEL DIXON SHANE |
| Credential | M.D. |
| Practice Address |
121 Sotoyome St Santa Rosa CA 95405-4823 |
| Practice Telephone | 7075464062 |
| Practice Fax Number | 7075786258 |
| Mailing Telephone | 7075464062 |
| Mailing Fax Number | 7075786258 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2009-07-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
C30136 | CA | Allopathic & Osteopathic Physicians |
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
C30136 | CA | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
C30136 | CA | Allopathic & Osteopathic Physicians |
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
C30136 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00C301360 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225284888 | Michael Bryan Shane | Anesthesiology | 5841 S Maryland Ave, Mc 4028, Chicago, IL 60637-1447 | 2008-08-14 |
| 1558561621 | Michael G Shane | Dentist | 350 Garfield St, Lander, WY 82520-3124 | 2007-07-18 |
| 1689797185 | Michael S. W. Shane | Dentist | 4866 Cooper Rd, Suite 201, Cincinnati, OH 45242-6904 | 2007-04-09 |
| Street Address |
121 SOTOYOME ST |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405-4823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023089729 | Marlene Patricia Lennon | Nurse Practitioner | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2006-01-30 |
| 1821417296 | Nicholas Mcgarvey | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2014-04-14 |
| 1326461708 | Redwood Radiology Group Inc | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2014-01-21 |
| 1225471337 | Alexander Page | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2013-04-09 |
| 1275819641 | Kathleen A Mott | Nurse Practitioner | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2011-10-28 |
| 1720373376 | Anusuya Mokashi | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2011-06-12 |
| 1558651091 | Vivek G. Sahani | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2011-04-18 |
| 1043531643 | Gary Raymond Roper | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2010-06-17 |
| 1316176712 | Lesley M Field | Physician Assistant | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2009-07-07 |
| 1578797601 | Raymond F. Conway IIi | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2009-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689890444 | Santa Rosa Imaging Medical Center | Radiology | 3536 Mendocino Ave Ste 280, Santa Rosa, CA 95403-3634 | 2007-04-18 |
| 1689740292 | Shirley Esther Beshany | Radiology | 640 Jean Marie Drive, Santa Rosa, CA 95403 | 2006-11-27 |
| 1245241462 | Redwood Regional Medical Group, Inc. | Radiology | 3540 Mendocino Ave Ste 100, Santa Rosa, CA 95403-2276 | 2006-08-11 |
| 1053342212 | Durba Dutta | Radiology | 3883 Airway Dr Ste 100, Santa Rosa, CA 95403 | 2006-07-06 |
| 1184245870 | Dona Pierantoni Brumbley | Radiology | 1701 4th St, Santa Rosa, CA 95404-3658 | 2020-05-04 |
| 1821417296 | Nicholas Mcgarvey | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2014-04-14 |
| 1326461708 | Redwood Radiology Group Inc | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2014-01-21 |
| 1336481886 | Steven J Rockoff | Radiology | 3883 Airway Dr Ste 100, Santa Rosa, CA 95403-1672 | 2013-03-22 |
| 1720373376 | Anusuya Mokashi | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2011-06-12 |
| 1043531643 | Gary Raymond Roper | Radiology | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2010-06-17 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
Please comment or provide details below to improve the information on MICHAEL DIXON 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.