Kimberly Marie Shanks, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

676752 Issued in TX

Practice address

431 Meadowlark Rd
Shaw Afb, SC 29152

Phone

(803) 895-6592

NPI assigned

Feb 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195776000000",
    "number": "1366415184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 MEADOWLARK RD",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "29152",
            "telephone_number": "803-895-6592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 MEADOWLARK RD",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "29152",
            "telephone_number": "803-895-6592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKS",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2007-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "676752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorraine Rivero, NP
• Gerardo Robles Morales
• Jeffrey A. Schievenin, M.D.
• Christopher Schreiner
• Victoria Sefcsik-Revelle, DO
• Rebecca Sarah Slogic, M.D.
• Mallory Smith, NP
• Melissa Ann Smith, MS, ATC
• Nathan Augustine Sollenberger, PHD
• Jessica Lauren Starnes, DMD

• All providers in Shaw Afb, SC
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; 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.