Diane Allen Shuck

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

14062 Issued in TN

Practice address

5623 Ooltewah Ringgold Rd
Ooltewah, TN 37363-7806

Phone

(423) 238-5668

Fax

(423) 238-5170

NPI assigned

May 10, 2006

Last updated

Feb 5, 2010By 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 1

Addresses

Other identifiers 3

Other names 1

• Dr. Linda Diane Allen Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265328000000",
    "number": "1801845383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5623 OOLTEWAH RINGGOLD RD",
            "address_2": "PO BOX 731",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373637806",
            "telephone_number": "423-238-5668",
            "fax_number": "423-238-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5623 OOLTEWAH RINGGOLD RD",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373637806",
            "telephone_number": "423-238-5668",
            "fax_number": "423-238-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUCK",
        "first_name": "DIANE",
        "middle_name": "ALLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2010-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "14062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0036498",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3009848",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "010010624",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "ALLEN",
            "middle_name": "DIANE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Malcolm Drew Shabo, D.D.S.
• Cynthia Fernandez Shaffer, NP-C
• Emma Jean Shelby
• Tara L Shepherd, RDH
• Allen T Sherwood, M.D.
• Silversage Physician Services of Tennessee, PLLC
• Logan Sims, DPT
• John Clinton Sinclair, LMT
• John A. Sines Jr., D.D.S.
• Kelsey Lynn Sivley, PT, DPT

• Internal Medicine Physician in Ooltewah, TN
• Providers in Ooltewah, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2010; 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.