Active NPI
Michael Shenkman, MD
- Internal Medicine Physician
- Winchester, TN
National Provider Identifier
1932176740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 034964
- Practice address
- 81 Memorial Dr
Winchester, TN 37398-2401 - Phone
- (931) 967-7171
- Fax
- (931) 967-3131
- NPI assigned
- Mar 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 034964 | TN | Primary |
Addresses
Primary practice location
81 Memorial Dr
Winchester, TN 37398-2401
Mailing address
81 Memorial Dr
Winchester, TN 37398-2401
Phone (931) 967-7171
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3861802 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 034964 | TN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Ventures, Inc | Past | Accepting new patients | |
| Fauster Cameron Inc. | Past | Accepting new patients | |
| East Tennessee Women'S Care, PC | Past | Accepting new patients |
Organizations & group practices 3
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.
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- Specialist
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-
- Primary Care Clinic/Center
- Knoxville, TN
- NPI 1558563262
-
- Multi-Specialty Clinic/Center
- Defiance, OH
- NPI 1649253964
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374105600000",
"number": "1932176740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "81 MEMORIAL DR",
"city": "WINCHESTER",
"state": "TN",
"postal_code": "373982401",
"telephone_number": "931-967-7171",
"fax_number": "931-967-3131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "81 MEMORIAL DR",
"city": "WINCHESTER",
"state": "TN",
"postal_code": "373982401",
"telephone_number": "931-967-7171",
"fax_number": "931-967-3131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHENKMAN",
"first_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-01",
"last_updated": "2013-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TN",
"license": "034964",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3861802",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winchester, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.