Roderick Joseph Shanks Sr.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

4505 Issued in MS

Practice address

1636 N Popps Ferry Rd # A2 & A4
Biloxi, MS 39532-2217

Phone

(228) 967-7991

Fax

(228) 967-7999

NPI assigned

Jul 22, 2019

Last updated

Jul 22, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1548813272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 N POPPS FERRY RD # A2 & A4",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395322217",
            "telephone_number": "228-967-7991",
            "fax_number": "228-967-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 N POPPS FERRY RD # A2 & A4",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395322217",
            "telephone_number": "228-967-7991",
            "fax_number": "228-967-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKS",
        "first_name": "RODERICK",
        "middle_name": "JOSEPH",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MS",
            "license": "4505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Lynn Seymour, LCSW
• Kylie McKenna Shadoin, COTA
• Marianne Marie Shaffer, LCSW
• George Michael Shahin, M.D.
• Josh Shank
• Katelyn M Sharpe, PHD
• Shaunacey Valdez
• Sara Shaw, MA
• Jamie Weaver Shedden, MSN, ACNP
• Christopher L Shelby, M.D.

• In Home Supportive Care Agency in Biloxi, MS
• Providers in Biloxi, MS by specialty
• In Home Supportive Care Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.