Provider Demographics
NPI:1487981320
Name:LENSING, SHANNON M (DPM)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:M
Last Name:LENSING
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 SAMSON WAY
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-4307
Mailing Address - Country:US
Mailing Address - Phone:402-331-6387
Mailing Address - Fax:402-331-6537
Practice Address - Street 1:1301 N 72ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-1903
Practice Address - Country:US
Practice Address - Phone:402-932-4727
Practice Address - Fax:402-932-4729
Is Sole Proprietor?:No
Enumeration Date:2009-11-13
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE320213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1427348838OtherGROUP NPI; NEBRASKA LOWER EXTREMITY SURGERY GROUP
NE10025518200Medicaid
NE10025518000Medicaid
NE10025518100Medicaid
NE10025640100Medicaid
NE10025518200Medicaid
NE10025518100Medicaid
NE10025518000Medicaid
NENA1914Medicare PIN
NENA1915005Medicare PIN