Vanessa Jane Shank, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

01056852A Issued in IN

Practice address

289 Ireland Ave
Ireland Army Community Hospital
Fort Knox, KY 40121-5111

Phone

(502) 624-9864

NPI assigned

Nov 23, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1053394940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 MARY LEE ST",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427014481",
            "telephone_number": "859-839-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 IRELAND AVE",
            "address_2": "IRELAND ARMY COMMUNITY HOSPITAL",
            "city": "FORT KNOX",
            "state": "KY",
            "postal_code": "401215111",
            "telephone_number": "502-624-9864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANK",
        "first_name": "VANESSA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01056852A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL PRACTICE",
            "identifier": "01056852A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anna Sage, LICSW,MAC
• Lauren Beth Sandmire, L.I.S.W.
• Joshua Schroeder, PA-C
• Robert Jay Selders Jr., D.M.D., M.S.D.
• Martin Joseph Setter, D.P.M.
• Robyn Sharier, AUD
• Jason N. Sharp, PA-C
• William Oakley Shelton, M.A.
• Karen Lynn Shines, D.M.D.
• Brian Jacobs Shiozawa, MD, MPH, MHA, FACOEM

• General Practice Physician in Fort Knox, KY
• Providers in Fort Knox, KY by specialty
• General Practice Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.