KENNETH ALLAN SHANE DPM NPI 1790812188

NPI Information

NPI: 1790812188
Provider Name: KENNETH ALLAN SHANE, DPM
Classification: Podiatrist - 213E00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3381 MONTROSE AVENUE
AKRON, OH
ZIP 44333
Phone: (330) 666-6801
Get Directions

Kenneth Allan Shane, DPM is a podiatrist in Akron, OH. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. Kenneth Allan Shane, DPM NPI is 1790812188. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3381 MONTROSE AVENUE
AKRON, OH
ZIP 44333-411
Phone: (330) 666-6801
Fax: (330) 666-6801

The NPI 1790812188 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 2/27/2007 and was last updated on 7/4/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213E00000X	Podiatrist		36002062	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	T80541	MEDICARE UPIN
2	SH0520022	OTHER		STANDARD LIFE AND ACCIDEN
3	480003668	OTHER	GEORGIA	RAILROAD MEDICARE
4	0561682	MEDICAID	OHIO
5	341466072	OTHER		UNITED AMERICAN INSURANCE
6	000000132340	OTHER	OHIO	ANTHEM BLUE CROSS BLUE SH
7	000000165933	OTHER	KENTUCKY	ANTHEM BLUE CROSS BLUE SHIELD
8	0007763250	OTHER	TEXAS	AETNA
9	SH0520022	MEDICARE ID-TYPE UNSPECIFIED	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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