Charles B Shane, M.D.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

18903 Issued in KY

Practice address

205 Sycamore Hills CT
Louisville, KY 40245-5095

Phone

(502) 243-8330

Fax

(502) 243-8330

NPI assigned

Feb 10, 2006

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Charles B Shane MD PSC

  • Gynecology Physician
  • Louisville, KY
  • NPI 1215067780
  NPD (past) Authorized official

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788652800000",
    "number": "1386617298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SYCAMORE HILLS CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402455095",
            "telephone_number": "502-243-8330",
            "fax_number": "502-243-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SYCAMORE HILLS CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402455095",
            "telephone_number": "502-243-8330",
            "fax_number": "502-243-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANE",
        "first_name": "CHARLES",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2026-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "KY",
            "license": "18903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000068700",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64189038",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beanka N Shamoun, DMD
• Sandra D. Shanaberger, P.A.-C.
• Debra Shanahan, CRNA
• Matilyn Maeve Shanahan
• Patrick Thomas Shanahan, M.D.
• Whoy Yurn Shang, APRN
• Angela Kay Shanks, COTA/L
• Jennifer Shanks, LCSW, LCADC
• Shannon M Barnett (Hands of Love)
• Shannon P Johnson DMD PLLC

• 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 Sep 6, 2026; 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.