Individual provider Active NPI

Ryan Henry Shanks, MD

  • Emergency Medicine Physician
  • Chapel Hill, NC
National Provider Identifier
1275853384
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
49979 Issued in TN
Practice address
170 Manning Dr
Department of Emergency Medicine, CB# 7594
Chapel Hill, NC 27514-4221
Phone
(919) 966-6440
Fax
(919) 966-3049
NPI assigned
Jun 11, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 49979 TN Primary

Addresses

Primary practice location

170 Manning Dr
Department of Emergency Medicine, CB# 7594
Chapel Hill, NC 27514-4221

Mailing address

170 Manning Dr
Department of Emergency Medicine, CB# 7594
Chapel Hill, NC 27514-4221
Phone (919) 966-6440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130917000207 TN Practitioner - Emergency Medicine 1355586124 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
49979TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
App of Tennessee Ed, PLLC Emergency Medicine CurrentSince Apr 1, 2014 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2013 Accepting new patients
Emergency Physician Associates of North Carolina, P.C. Emergency Medicine Past Accepting new patients

Locations

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1275853384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MANNING DR",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE, CB# 7594",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144221",
            "telephone_number": "919-966-6440",
            "fax_number": "919-966-3049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MANNING DR",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE, CB# 7594",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144221",
            "telephone_number": "919-966-6440",
            "fax_number": "919-966-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKS",
        "first_name": "RYAN",
        "middle_name": "HENRY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "49979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.