Individual provider Active NPI

Devon Shock, AUD

  • Audiologist
  • Lexington, KY
National Provider Identifier
1205355856
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
174513 Issued in KY
Practice address
120 N Eagle Creek Dr Ste 102
Lexington, KY 40509-1827
Phone
(859) 629-7140
NPI assigned
Sep 14, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 174513 KY Primary

Addresses

Primary practice location

120 N Eagle Creek Dr Ste 102
Lexington, KY 40509-1827

Mailing address

120 N Eagle Creek Dr Ste 102
Lexington, KY 40509-1827
Phone (859) 629-7140

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

State licenses

LicenseStateTypeSpecialty
174513KYMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205355856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N EAGLE CREEK DR STE 102",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091827",
            "telephone_number": "859-629-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N EAGLE CREEK DR STE 102",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091827",
            "telephone_number": "859-629-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCK",
        "first_name": "DEVON",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KY",
            "license": "174513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

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.

Verify at the official NPI Registry.