Individual provider Active NPI

Shannon S Lamb, MD

  • Radiation Oncology Physician
  • Evansville, IN
National Provider Identifier
1891758272
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
01033374 Issued in IN
Practice address
700 N Burkhardt Rd
Evansville, IN 47715-2740
Phone
(812) 474-1110
Fax
(812) 471-9282
NPI assigned
Apr 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 01033374 IN Primary

Addresses

Primary practice location

700 N Burkhardt Rd
Evansville, IN 47715-2740

Mailing address

PO Box 2368
Indianapolis, IN 46206-2368
Phone (812) 474-1110

Other identifiers 4

IdentifierTypeStateIssuer
100319830MedicaidIN
3300262019MedicaidIL
360003672OtherRR MEDICARE TA
64756281MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20061229000228 IN Practitioner - Radiation Oncology 2062424989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Louisville School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-State Radiation Oncology Centers LLCGroup PAC ID 8628133394, 4 clinicians

Practice addresses (Care Compare)

700 N Burkhardt Rd
Evansville, IN 47715-2740
Phone (812) 474-1110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01033374INMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Radiation Oncology Centers LLC Radiation Oncology CurrentSince Dec 1, 2008 Accepting new patients

Locations

700 N Burkhardt Rd
Evansville, IN 47715
Phone (812) 474-1110

6225 E Columbia St
Evansville, IN 47715
Phone (812) 474-1110

4055 Gateway Blvd
Newburgh, IN 47630
Phone (812) 842-2210

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1891758272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2368",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462062368",
            "telephone_number": "812-474-1110",
            "fax_number": "812-474-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N BURKHARDT RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152740",
            "telephone_number": "812-474-1110",
            "fax_number": "812-471-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMB",
        "first_name": "SHANNON",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IN",
            "license": "01033374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100319830",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3300262019",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE TA",
            "identifier": "360003672",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64756281",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.