SHANNON GAIL STARK (NPI# 1003129438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003129438 |
| Entity Type | Individual |
| Full Name | SHANNON GAIL STARK |
| Credential | M.A. CCC/SLP, NP-C |
| Practice Address |
39 Pearl St W Sidney NY 13838 |
| Mailing Address |
205 Crocker Hill Rd Binghamton NY 13904-2513 |
| Practice Telephone | 6075612021 |
| Mailing Telephone | 2129279706 |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2019-02-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 235Z00000X | Speech-Language Pathologist | 0106541 | NY | Speech, Language and Hearing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
343815 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 31 Park Ter W, #b9, New York, NY 100341514 | 2129279706 |
| Street Address |
39 PEARL ST W |
| City | SIDNEY |
| State | NY |
| Zip Code | 13838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619978020 | Carlton James Rule | Family Medicine | 39 Pearl St W, Sidney, NY 13838-1330 | 2005-08-09 |
| 1689233488 | Lindsey Marie Schlaeg | Physician Assistant | 39 Pearl St W, Sidney, NY 13838-1330 | 2019-06-06 |
| 1235562570 | Rochelle Lee Cherrone | Nurse Practitioner | 39 Pearl St W, Sidney, NY 13838-1330 | 2013-08-09 |
| 1730419870 | Kenneth Edward Demott | Nurse Practitioner | 39 Pearl St W, Sidney, NY 13838-1330 | 2010-01-13 |
| 1760609382 | Connie Diane Kelly | Nurse Practitioner | 39 Pearl St W, Sidney, NY 13838-1330 | 2007-04-18 |
| 1558383620 | Leibing Tang | Internal Medicine | 39 Pearl St W, Sidney, NY 13838-1330 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689222341 | Christina Rutenber | Occupational Therapy Assistant | Edmeston Central School, 11 North St., Edmeston, NY 13838 | 2019-08-27 |
| 1669715199 | Valley Veterinary Associates | Veterinarian | 647 State Highway 7, Sidney, NY 13838 | 2013-04-03 |
| 1740441658 | Lutfallah T Swabini | Pharmacist | Main St and Steiner Rd, Sidney, NY 13838 | 2008-06-23 |
| 1063626752 | David Melvin Bornstein | Dentist | 39 Delaware Avenue, Sidney, NY 13838 | 2007-05-10 |
| 1952513947 | Joshua House Inc | Case Management | 10 Division Street, Sidney, NY 13838 | 2007-05-04 |
| 1124170873 | Bonnie Lynn Crist | Chiropractor | 106 River St, Sidney, NY 13838 | 2007-01-16 |
| 1801908553 | Rani Kapur-pado | Internal Medicine | 43 Pearl Street, 2nd Fl Suite 1a Rani Kapur-pado Do LLC, Sidney, NY 13838 | 2006-08-31 |
| 1083726731 | Rohan Senerat Jayasena | Pediatrics | 44 Pearl Street, Sidney, NY 13838 | 2006-08-31 |
| 1598264699 | Amelia Sutphin | Pharmacist | 10 Main St, Sidney, NY 13838 | 2018-02-05 |
| 1902227374 | Georgia A. Bell | Registered Nurse | 15 Pearl St. E, Elementary School Health Office, Sidney, NY 13838 | 2014-01-02 |
| Find all providers in zip 13838 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043868961 | Lisa A Monroe | Nurse Practitioner | 823 Michigan St Bldg A, Sidney, OH 45365-2685 | 2019-09-04 |
| 1144785098 | Fc Ohio, LLC | Nurse Practitioner | 2006 Michigan St, Sidney, OH 45365-9069 | 2019-02-05 |
| 1700370509 | Sydney Michelle Snyder | Nurse Practitioner | 915 Michigan St Ste 100, Sidney, OH 45365-2401 | 2018-06-15 |
| 1598838666 | Patti Iversen | Nurse Practitioner | 214 14th Ave Sw Ste 114, Sidney, MT 59270-3521 | 2006-11-16 |
| 1528690641 | Lyndsey North | Nurse Practitioner | 915 Michigan St, Sidney, OH 45365-2401 | 2020-02-06 |
| 1346888161 | Krista Jean Frank | Nurse Practitioner | 216 14th Ave Sw, Sidney, MT 59270-3519 | 2019-12-11 |
| 1588219109 | Meaghan Leigh Provost | Nurse Practitioner | 44 Pearl St W, Sidney, NY 13838-1325 | 2019-08-09 |
| 1467946780 | Tammie I Kelton | Nurse Practitioner | 915 Michigan St, Sidney, OH 45365-2401 | 2018-06-20 |
| 1538614730 | Elizabeth Rosa | Nurse Practitioner | 59 River St, Sidney, NY 13838-1035 | 2016-08-18 |
| 1295188233 | Megan Greve | Nurse Practitioner | 915 Michigan St, Suite 100, Sidney, OH 45365-2401 | 2016-07-14 |
| Find all providers in SIDNEY | ||||
Please comment or provide details below to improve the information on SHANNON GAIL STARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.