Edwin J Shakun, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01047025A Issued in IN

Practice address

1001 N Madison Ave
Greenwood, IN 46142-4135

Phone

(317) 888-3508

NPI assigned

Jun 1, 2005

Sex

Male

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 2

Electronic endpoints 1

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

Interoperability endpoints

• Direct secure messaging: eshakun172809@direct.franciscanalliance.org

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.

• St. Mary's Health, Inc

  dba Ascension St. Vincent Evansville

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1497706287
  NPD (past)

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1467454660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 771846",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781846",
            "telephone_number": "317-528-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N MADISON AVE",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461424135",
            "telephone_number": "317-888-3508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKUN",
        "first_name": "EDWIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2023-03-07",
        "certification_date": "2021-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01047025A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSR",
            "identifier": "01047025B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA LICENSE",
            "identifier": "01047025A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eshakun172809@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1001 N Madison Ave",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461424135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shannon Rae Shaffer, MA, CCC-SLP
• Stacy Shaffer, RBT
• Haider Raza Shah, MD
• Kushal J Shah, M.D.
• Palak V Shah, MSPEX, PT, CPMT
• Kayla Shambarger, NP
• Sarosh A Shamsi, DMD
• Caitlyn Shane
• Shank Orthodontics, LLC
• Stephanie Brooke Shank, DDS, MS

• Internal Medicine Physician in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.