David E. Shanks, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DAVID E. SHANKS, PA

Practice address

3717 Latrobe Dr Ste 750
Charlotte, NC 28211-4826

Phone

(704) 364-6676

Fax

(704) 364-1358

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

David E Shanks, PA

Title

Corporation

Phone

(704) 364-6676

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251158400000",
    "number": "1154490746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3717 LATROBE DR STE 750",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114826",
            "telephone_number": "704-364-6676",
            "fax_number": "704-364-1358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3717 LATROBE DR STE 750",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114826",
            "telephone_number": "704-364-6676",
            "fax_number": "704-364-1358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID E. SHANKS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2009-08-25",
        "status": "A",
        "authorized_official_last_name": "SHANKS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CORPORATION",
        "authorized_official_telephone_number": "704-364-6676",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8975428",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RR MEDICARE",
            "identifier": "406291010",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "30596",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "75428",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David E Thome DDS PLLC XI
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• David E Thome DDS PLLC Xiii
• David E Thome DDS PLLC Xiv
• David H. Moore DDS, Ms, PA
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• David H. Roberts MD PC
• David Hendrick DDS PLLC III
• David Ritchie DC PC

• Internal Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.