Provider Demographics
NPI:1568190890
Name:SHRINKTY MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:SHRINKTY MEDICAL SERVICES, LLC
Other - Org Name:SHRINKTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVENPORT
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:615-716-8255
Mailing Address - Street 1:105 N MAPLE ST STE 4
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-3524
Mailing Address - Country:US
Mailing Address - Phone:615-716-8255
Mailing Address - Fax:
Practice Address - Street 1:105 N MAPLE ST STE 4
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-3524
Practice Address - Country:US
Practice Address - Phone:931-808-7504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-14
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty