DR. SHANE A AVERY (NPI# 1568452696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568452696 |
| Entity Type | Individual |
| Full Name | DR. SHANE A AVERY |
| Credential | MD |
| Practice Address |
1469 North Gardner Scottsburg IN 47170-0290 |
| Mailing Address |
1469 North Gardner Po Box 290 Scottsburg IN 47170-0290 |
| Practice Telephone | 8127521151 |
| Practice Fax Number | 8127521152 |
| Mailing Telephone | 8127521151 |
| Mailing Fax Number | 7127521152 |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2017-03-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 01045558A | IN | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 01045558A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201163750A | 05 | |
| IN | ANTHEM | 000000042772 | 01 |
| Street Address |
1469 NORTH GARDNER |
| City | SCOTTSBURG |
| State | IN |
| Zip Code | 47170-0290 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962065565 | Mfdc of Indiana, Inc | Dentist | 1606 W Mcclain Ave, Scottsburg, IN 47170 | 2019-04-18 |
| 1003211392 | Forefront Dermatology, S.c. | Dermatology | 1473 N Gardner St Ste A, C/o Scott Memorial Hospital, Scottsburg, IN 47170 | 2014-10-29 |
| 1154750800 | Kimberly Burns | Occupational Therapy Assistant | 545 W. Moonglo Rd, Scottsburg, IN 47170 | 2013-11-04 |
| 1700127800 | Janet M Buhse Md PC | Family Medicine | 941 W Mcclain Ave Ste C, Scottsburg, IN 47170 | 2013-03-14 |
| 1972826402 | Harold H Rumley | Counselor | 75 North First Street, Scottsburg, IN 47170 | 2010-03-11 |
| 1245497213 | Samaritan Behavioral Healthcare | Counselor | 969 W Mcclain Ave, Suite B, Scottsburg, IN 47170 | 2008-05-19 |
| 1801061858 | Gardner Street Emergency Physicians | Emergency Medicine | 1451 N. Gardner Street, Scottsburg, IN 47170 | 2008-04-29 |
| 1689859621 | Samaritan Behavioral Healthcare | Counselor | 969 W. Mcclain Ave, Suite B, Scottsburg, IN 47170 | 2008-01-09 |
| 1760674998 | Darshana Patel | Internal Medicine | 1467 Scott Valley Dr, Scottsburg, IN 47170 | 2007-08-12 |
| 1669663977 | Wwindell Go Ellorimo | Physical Therapist | 545 Moonglo Rd, Scottsburg, IN 47170 | 2007-08-05 |
| Find all providers in zip 47170 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700127800 | Janet M Buhse Md PC | Family Medicine | 941 W Mcclain Ave Ste C, Scottsburg, IN 47170 | 2013-03-14 |
| 1124372131 | Scottsburg Family Healthcare Inc | Family Medicine | 1465 N. Gardner St., Scottsburg, IN 47170-7751 | 2012-10-30 |
| 1700045374 | Jennifer M. Craig Md PC | Family Medicine | 1469 N. Gardner Street, Ste. #2, Scottsburg, IN 47170-7751 | 2008-06-08 |
| 1346448354 | Nandalal Yepuri Scottsburg LLC | Family Medicine | 1185 N Gardner St, Scottsburg, IN 47170-1417 | 2007-07-11 |
| 1891801312 | Eusebio C Kho | Family Medicine | 137 East Mcclain Ave, Scottsburg, IN 47170-1846 | 2006-08-21 |
| 1912923285 | St. Luke's Medical Ministry | Family Medicine | 1441 N Gardner, Scottsburg, IN 47170-0677 | 2006-07-13 |
| 1609859388 | Coordinated Health LLC | Family Medicine | 1366 N Gardner St, Ste 140, Scottsburg, IN 47170-7793 | 2005-11-28 |
| 1821079674 | Janet Marie Buhse | Family Medicine | 941 W Mcclain St, Suite C, Scottsburg, IN 47170-1158 | 2005-11-09 |
| 1851395693 | Jennifer Mae Craig | Family Medicine | 1465 N. Gardner Street, Scottsburg, IN 47170 | 2005-06-09 |
| 1821579137 | R. Kevin Rogers Md | Family Medicine | 1473 N Gardner St, Scottsburg, IN 47170-7751 | 2018-08-24 |
| Find all providers in SCOTTSBURG | ||||
| City | SCOTTSBURG |
| Zip Code | 47170 |
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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.