Jack Shenouda MD Corp

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

JACK SHENOUDA MD CORP

Practice address

1016 Cactus CT
Thousand Oaks, CA 91320-5907

Phone

(717) 557-3938

NPI assigned

Oct 2, 2018

Organization subpart

No

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

Authorized official

Name

Jack Shenouda, MDNPI 1023247822

Title

Ceo

Phone

(717) 557-3938

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jack Shenouda, M.D.

  • Hospitalist Physician
  • Oxnard, CA
  • NPI 1023247822

  Internal Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538438400000",
    "number": "1962987222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 CACTUS CT",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913205907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 CACTUS CT",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913205907",
            "telephone_number": "717-557-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK SHENOUDA MD CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-02",
        "last_updated": "2018-10-02",
        "status": "A",
        "authorized_official_last_name": "SHENOUDA",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "717-557-3938",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marsha Gay Izen, MFT
• J Thomas Millington, MD a Medical Corporation
• J. B. Wilmeth, M.D., Inc.
• Briana Jacinto
• Jack C Chang, DDS Inc
• Jacob & Henein a Medical Corporation
• Christina N Jacob, M.D.
• Cynthia A Jacobson, CRNA, MS
• Daryoush Jadali, M.D.
• Jaesung Lee

• Internal Medicine Physician in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.