Active NPI
J. Christopher Shank, M.D.
- Family Medicine Physician
- Thorntown, IN
National Provider Identifier
1124015532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01046198
- Practice address
- 151 E Bow St
Thorntown, IN 46071-1164 - Phone
- (765) 436-2400
- Fax
- (765) 436-7375
- NPI assigned
- Sep 30, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01046198 | IN | Primary |
Addresses
Primary practice location
151 E Bow St
Thorntown, IN 46071-1164
Mailing address
2705 N Lebanon St Ste 305
Lebanon, IN 46052-8622
Phone (765) 485-8852
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200126160 | Medicaid | IN |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01046198 | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Family Physicians, Inc. | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Indianapolis, IN
- NPI 1043275787
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1124015532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2705 N LEBANON ST STE 305",
"city": "LEBANON",
"state": "IN",
"postal_code": "460528622",
"telephone_number": "765-485-8852",
"fax_number": "765-485-8669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 E BOW ST",
"city": "THORNTOWN",
"state": "IN",
"postal_code": "460711164",
"telephone_number": "765-436-2400",
"fax_number": "765-436-7375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANK",
"first_name": "J.",
"middle_name": "CHRISTOPHER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-30",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01046198",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200126160",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Thorntown, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.