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ELIZABETH SHAKE
NPI 1609432285
Student in an Organized Health Care Education/Training Program in Augusta, GA

Active since May 19, 2019PECOS Enrolled
1475 LANEY WALKER BLVD, AUGUSTA, GA 30912(706) 721-7005 Get Directions Write a Review

NPPES record last updated: June 30, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 5, 2021, May 19, 2019 (2 updates tracked since 2019).

About Elizabeth Shake NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELIZABETH SHAKE (NPI 1609432285) is an individual student in an organized health care education/training program in Augusta, Georgia and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1609432285
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameELIZABETH SHAKE
Location Address1475 LANEY WALKER BLVDAugusta, GA 30912-0002
Mailing Address1475 Laney Walker BlvdAugusta, GA 30912-0002 · (706) 721-7005
Phone(706) 721-7005
Sole ProprietorNo
Enumeration DateMay 19, 2019
Last NPPES UpdateJune 30, 20222 updates tracked since enumeration
NPPES CertifiedJune 30, 2022
✔ NPI 1609432285 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1475 LANEY WALKER BLVD, Augusta, GA 30912
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Secondary Practice Locations 2

Location 11924 Alcoa Hwy # U-11Knoxville, TN 37920-1511 · Phone (865) 305-9230 · Fax (865) 305-6958
Location 2500 S Preston St Rm 305Louisville, KY 40202-1702 · Phone (502) 852-8696

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elizabeth Shake is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAHNAVI KANDEPU
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
1475 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-7005
JELANI DIA BENDER MD
Emergency Medicine
1475 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-7005
MICHAEL PHILIP CONSTANS DO
Student in an Organized Health Care Education/Training Program
1475 LANEY WALKER BLVD, AE-3046
AUGUSTA, GA 30912
Richmond County (706) 721-7005
RAWAN KORMAN MD
Pediatrics
1475 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-5036
GABRIELLE MARA MOORE MD
Surgery
1475 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-7005
ANKIT DHIMAN
Surgery
1475 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-7005
DR. ANTHONY GEORGE CAMPBELL MD
Surgery
1475 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-2503
GABRIELLA F WESTON MD
Emergency Medicine
1475 LANEY WALKER BLVD
AUGUSTA, GA 30912
Richmond County (706) 721-7005

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elizabeth Shake's NPI number?

The NPI number for Elizabeth Shake is 1609432285. It was assigned to this individual provider in the NPPES registry on May 19, 2019.

Where is Elizabeth Shake located?

Elizabeth Shake practices at 1475 Laney Walker Blvd, Augusta, GA 30912. The listed phone number is (706) 721-7005.

What is Elizabeth Shake's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Elizabeth Shake enrolled in Medicare?

Yes. Elizabeth Shake is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Elizabeth Shake was last updated on June 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.