CHARLES B SHANE MD PSC (NPI# 1215067780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215067780 |
| Entity Type | Organization |
| Organization Name | CHARLES B SHANE MD PSC |
| Practice Address |
4001 Kresge Way Suite 315 Louisville KY 40207-4640 |
| Practice Telephone | 5028957445 |
| Practice Fax Number | 5028956638 |
| Mailing Telephone | 5028957445 |
| Mailing Fax Number | 5028956638 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2009-02-24 |
| Authorized Official Name | CHARLES B SHANE (OWNER PHYSICIAN) |
| Authorized Official Telephone | 5028957445 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| 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 | ANTHEM | 000000068700 | 01 |
| KY | 64189038 | 05 |
| Street Address |
4001 KRESGE WAY SUITE 315 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40207-4640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710980842 | Stacie Grossfeld | Specialist | 4001 Kresge Way, Ste 330, Louisville, KY 40207-4640 | 2005-05-23 |
| 1982144358 | Orthopaedic Specialists Pllc | Non-Pharmacy Dispensing Site | 4001 Kresge Way, Suite 330, Louisville, KY 40207-4640 | 2017-03-03 |
| 1205283017 | Olivia Price | Physician Assistant | 4001 Kresge Way, Ste 210, Louisville, KY 40207-4640 | 2016-05-22 |
| 1396117131 | Graf Family Dentistry, Psc | Dentist | 4001 Kresge Way, Suite 120, Louisville, KY 40207-4640 | 2015-10-20 |
| 1952743940 | Andrew D. Morris | Physician Assistant | 4001 Kresge Way, Suite 200, Louisville, KY 40207-4640 | 2013-07-19 |
| 1588922652 | Steve P Kuric Md Pllc | Neurological Surgery | 4001 Kresge Way, Suite 238, Louisville, KY 40207-4640 | 2012-04-26 |
| 1053678359 | Janet L Honchell | Obstetrics & Gynecology | 4001 Kresge Way, Suite 324, Louisville, KY 40207-4640 | 2012-04-12 |
| 1356620322 | Baptist Medical Associates | Surgery | 4001 Kresge Way, Suite 210, Louisville, KY 40207-4640 | 2011-08-09 |
| 1104123041 | Andrew D Bailey Md | Clinical Nurse Specialist | 4001 Kresge Way, Suite 130, Louisville, KY 40207-4640 | 2011-02-11 |
| 1558534859 | Alberto Sebastian Gallo | Surgery | 4001 Kresge Way, Suite 200, Louisville, KY 40207-4640 | 2008-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780212688 | Alexia Louise Bodamer | Student in an Organized Health Care Education/Training Program | 142 Chenoweth Lane, Lousiville, KY 40207 | 2020-03-28 |
| 1467918664 | Amy Rock LLC | Counselor | 4010 Dupont Cir Ste 307, Louisville, KY 40207 | 2019-02-13 |
| 1649745191 | Louisville Optometric Center, IIi, Psc | Optometrist | 285 Hubbards Lane, Suite 300, Louisville, KY 40207 | 2018-10-11 |
| 1184137440 | Crimson Dove Counseling Services Inc | Community/Behavioral Health | 214 Breckenridge Ln., Suite 203, Louisville, KY 40207 | 2017-11-09 |
| 1285157586 | Dickerson Family Enterprise, LLC | Non-emergency Medical Transport (VAN) | 4350 Brownsboro Rd., Ste. 110, Louisville, KY 40207 | 2017-07-19 |
| 1578085296 | Cardiovascular Medical Specialists LLC | Surgery | 100 Mallard Creek Rd Ste 150, Louisville, KY 40207 | 2017-07-14 |
| 1932636305 | Devon Turley | Prevention Professional | 1017 Dupont Rd, Suite 1, Louisville, KY 40207 | 2017-05-17 |
| 1285095539 | Emily Schwartz Crouch | Marriage & Family Therapist | 4010 Dupont Circle, Suite 582, Louisville, KY 40207 | 2016-03-15 |
| 1306201280 | A A and Associates Approved Alcohol/drug Program | Counselor | 4006 Dutchmans Lane, Louisville, KY 40207 | 2015-12-21 |
| 1629433693 | Jewish Hospital and St. Mary's Healthcare, Inc. | General Acute Care Hospital | 3290 Dutchmans Lane, Louisville, KY 40207 | 2015-12-17 |
| Find all providers in zip 40207 | ||||
| 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 |
| 1386617298 | Charles B Shane | Obstetrics & Gynecology | 205 Sycamore Hills Ct, Louisville, KY 40245-5095 | 2006-02-10 |
| 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 |
| 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 | 40207 |
Please comment or provide details below to improve the information on CHARLES B SHANE MD PSC.
| 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.