Active NPI
Dana Shanks, MA
- Speech-Language Pathologist
- Wichita, KS
National Provider Identifier
1114690450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3972
- Practice address
- 14884 E Sundance St
Wichita, KS 67230-7162 - Phone
- (316) 841-9567
- NPI assigned
- Jul 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3972 | KS | Primary |
Addresses
Primary practice location
14884 E Sundance St
Wichita, KS 67230-7162
Mailing address
14884 E Sundance St
Wichita, KS 67230-7162
Phone (316) 841-9567
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3972 | Other | KS | KANSAS DEPARTMENT OF HEALTH OCCUPATIONS CREDENTIALING NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3972 | KS | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627603200000",
"number": "1114690450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14884 E SUNDANCE ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672307162",
"telephone_number": "316-841-9567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14884 E SUNDANCE ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672307162",
"telephone_number": "316-841-9567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANKS",
"first_name": "DANA",
"name_prefix": "Mrs.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-30",
"last_updated": "2021-07-30",
"certification_date": "2021-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "KS",
"license": "3972",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KANSAS DEPARTMENT OF HEALTH OCCUPATIONS CREDENTIALING NUMBER",
"identifier": "3972",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.