Fred Shanks, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

558 Issued in TN

Practice address

412 Elysian Field Rd
Nashville, TN 37211

Phone

(615) 834-8495

Fax

(615) 833-1143

NPI assigned

Jan 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fred R Shanks O.D., L.L.C.

  • Optometrist
  • Nashville, TN
  • NPI 1811731110
  NPD Authorized official

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1306991906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 ELYSIAN FIELD RD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37211",
            "telephone_number": "615-834-8495",
            "fax_number": "615-833-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 ELYSIAN FIELD RD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37211",
            "telephone_number": "615-834-8495",
            "fax_number": "615-833-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKS",
        "first_name": "FRED",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3593637A",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tassel Faith Shanebrook, PHD, LMFT
• Therese Colette Shank, APRN
• Angela Marie Shankle, MS, LADAC II
• Steven Shankle, M.D.
• Ebonique Rochelle Shanks, CNM
• Leah Shanks, LPC
• Shannon C Hall, LLC
• Shamya Shannon
• Mohamed Shanshal, M.D.
• Shape Behavioral Services LLC

• Optometrist in Nashville, TN
• Providers in Nashville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.