Shannon Vickery, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9092 Issued in KY

Practice address

9706 Taylorsville Rd
Louisville, KY 40299-2753

Phone

(502) 267-0546

Fax

(502) 267-7306

NPI assigned

Aug 18, 2006

Last updated

Mar 22, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Scharfenberger Family Dentistry, PSC

  • General Practice Dentistry
  • Louisville, KY
  • NPI 1639196660
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1427162544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9706 TAYLORSVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992753",
            "telephone_number": "502-438-5387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9706 TAYLORSVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992753",
            "telephone_number": "502-267-0546",
            "fax_number": "502-267-7306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERY",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "5165",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5165",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salvator Vicario, MD
• Karen Vicars
• Jennifer Vick
• Gary Wilbur Vickers, O.D.
• Paulette Vickery, LCSW, LMFT
• Vicki Cochran DMD, PSC
• Vicki S Ragsdell, PHD PLLC (Ragsdell and Associates)
• Ryan Vicknair
• Victoria Hatfield LLC
• Victoria Yunker MD

• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.