Theresa Joanne Shanley, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

5533 Issued in AK

Practice address

1650 Cowles St
Fairbanks, AK 99701-5925

Phone

(907) 458-5660

NPI assigned

Aug 19, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Radiology Consultants a Professional Corp

  • Diagnostic Radiology Physician
  • Fairbanks, AK
  • NPI 1124056734
  NPD (past)
• North Country Hospital & Health Center Inc

  • Critical Access Hospital
  • Newport, VT
  • NPI 1144251059
  NPD (past)
• North Country Hospital and Health Center Inc

  • Psychiatry Physician
  • Newport, VT
  • NPI 1962533877
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457466823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70378",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997070378",
            "telephone_number": "907-456-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015925",
            "telephone_number": "907-458-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANLEY",
        "first_name": "THERESA",
        "middle_name": "JOANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AK",
            "license": "5533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD7338",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendra Kay Shaner, OTR/L, CHT
• Shangri'la Ranch
• Chance Shank
• Cicely Shankle
• Kelly Shanklin
• Vanessa Shannon
• Nisha Sharma
• Brandie Price Sharp, ACCNS-AG, RNFA
• Darcey Rae Sharp
• David Scott Sharp, M.D.

• Diagnostic Radiology Physician in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Diagnostic Radiology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.