Individual provider Active NPI

Donna Lynn Shine, MD

  • Obstetrics & Gynecology Physician
  • Knoxville, TN
National Provider Identifier
1417978404
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD0000017231 Issued in TN
Practice address
501 19TH Street
Suite 509
Knoxville, TN 37916-1853
Phone
(865) 524-3208
Fax
(865) 522-4322
NPI assigned
Jul 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 17231 TN
Obstetrics & Gynecology Physician 207V00000X MD0000017231 TN Primary

Addresses

Primary practice location

501 19TH Street
Suite 509
Knoxville, TN 37916-1853

Mailing address

501 19TH Street
Suite 509
Knoxville, TN 37916-1853
Phone (865) 524-3208

Other identifiers 1

IdentifierTypeStateIssuer
3024047MedicaidTN

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

Interoperability endpoints

  • Direct secure messaging: donna.shine.1@16930.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276214400000",
    "number": "1417978404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 19TH STREET",
            "address_2": "SUITE 509",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161853",
            "telephone_number": "865-524-3208",
            "fax_number": "865-522-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 19TH STREET",
            "address_2": "SUITE 509",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161853",
            "telephone_number": "865-524-3208",
            "fax_number": "865-522-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINE",
        "first_name": "DONNA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2010-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "17231",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "MD0000017231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3024047",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; 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.