Individual provider Active NPI

Gregory I Shenk, M.D.

  • Specialist
  • Casa Grande, AZ
National Provider Identifier
1396793246
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
24970 Issued in AZ
Practice address
1669 E McMurray Blvd
Casa Grande, AZ 85222-6010
Phone
(520) 876-0297
Fax
(480) 889-3501
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 24970 AZ Primary

Addresses

Primary practice location

1669 E McMurray Blvd
Casa Grande, AZ 85222-6010

Mailing address

1840 W Apache TRL
Apache Junction, AZ 85220-3728
Phone (480) 889-3500

Other identifiers 1

IdentifierTypeStateIssuer
002936MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24970AZMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
MRI Associates of Illinois SC Past Accepting new patients
Libertyville Imaging Associates, Inc Past Accepting new patients
Aztech Radiology and Open MRI Specialist Past Accepting new patients
Premier Health Services Inc Past Accepting new patients
Aztech Radiology and Open MRI Specialist Past Accepting new patients
Aztech Radiology and Open MRI Specialist Past Accepting new patients
Az-Tech Radiology & Open MRI Specialist Past Accepting new patients
Aztech Radiology and Open MRI Specialist Past Accepting new patients

Organizations & group practices 8

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1396793246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 W APACHE TRL",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "852203728",
            "telephone_number": "480-889-3500",
            "fax_number": "480-889-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 E MCMURRAY BLVD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "852226010",
            "telephone_number": "520-876-0297",
            "fax_number": "480-889-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENK",
        "first_name": "GREGORY",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "24970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002936",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.