Charles B Shane MD PSC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

18903 Issued in KY

Legal business name

CHARLES B SHANE MD PSC

Practice address

4001 Kresge Way
Suite 315
Louisville, KY 40207-4640

Phone

(502) 895-7445

Fax

(502) 895-6638

NPI assigned

Mar 6, 2007

Organization subpart

No

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

Authorized official

Name

Charles B Shane, MDNPI 1386617298

Title

Owner Physician

Phone

(502) 895-7445

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles B Shane, M.D.

  • Gynecology Physician
  • Louisville, KY
  • NPI 1386617298
  NPD (past) Authorized official

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235433600000",
    "number": "1215067780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 KRESGE WAY",
            "address_2": "SUITE 315",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074640",
            "telephone_number": "502-895-7445",
            "fax_number": "502-895-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 KRESGE WAY",
            "address_2": "SUITE 315",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074640",
            "telephone_number": "502-895-7445",
            "fax_number": "502-895-6638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES B SHANE MD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2009-02-24",
        "status": "A",
        "authorized_official_last_name": "SHANE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "502-895-7445",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "KY",
            "license": "18903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64189038",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000068700",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James D Charasika, M.D.
• Alex James Charboneau, MD
• Jyme Rae Charette, DMD, MSD
• Mark E. Chariker, M.D.
• Charles a Kincaid PSC
• Charles E. Oates MD PLLC
• Charles Krebs Optical Shoppe
• Charming Home Care Agency LLC
• Monita Chary, MD
• Ravi Chary, MD

• Gynecology Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Gynecology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.