Shane Joseph, MD

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

A138026 Issued in CA

Practice address

695 Kinkaid Rd
Annapolis, MD 21402-1006

Phone

(410) 293-1152

NPI assigned

Jun 16, 2014

Last updated

Oct 29, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1568876837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 KINKAID RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214021006",
            "telephone_number": "410-293-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 KINKAID RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214021006",
            "telephone_number": "410-293-1152"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Farenholt Avenue",
            "address_2": "BLDG 50",
            "address_purpose": "LOCATION",
            "city": "Agana Heights",
            "state": "GU",
            "postal_code": "96910",
            "country_code": "US",
            "telephone_number": "671-344-9340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Naval Medical Ctr",
            "address_2": "34800 Bob Wilson Drive",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921345000",
            "country_code": "US",
            "telephone_number": "619-794-7615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-16",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CA",
            "license": "A138026",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A138026",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tristram Jones
• William Lafon Jones II, PHARMD, BCPS
• Whitney Jordan
• Judy Joseph-Herbert, MD
• Nadige Joseph, DR
• Linda O. Josephson, R.N.
• Stephanie Ann Joy, CRNP
• JRL and Associates
• John Jubar, M.D.
• Ann B Judge, PHD

• Preventive Medicine/Occupational Environmental Medicine Physician in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.