SHANNON MARIE BURGESS (NPI# 1205198637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205198637 |
| Entity Type | Individual |
| Full Name | SHANNON MARIE BURGESS |
| Credential | M.D. |
| Practice Address |
1809 Wade Hampton Blvd Suite 120 Greenville SC 29609-4041 |
| Mailing Address |
1 Independence Pt Suite 212 Greenville SC 29615-4545 |
| Practice Telephone | 8645227000 |
| Practice Fax Number | 8642419275 |
| Mailing Telephone | 8647976306 |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2016-08-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 34858 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | PENDING | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205324928 | Shannon N Burgess | Social Worker | 13422 Kinsman Rd, Cleveland, OH 44120-4410 | 2018-04-27 |
| 1457313835 | Shannon M Burgess | Optometrist | 1260 Valley Forge Rd, Suite 108, Phoenixville, PA 19460-2691 | 2006-04-03 |
| Street Address |
1809 WADE HAMPTON BLVD SUITE 120 |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29609-4041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629027990 | Kurt R Harding | Family Medicine | 1809 Wade Hampton Blvd, Suite 120, Greenville, SC 29609-4041 | 2006-05-06 |
| 1528424942 | Angela Uson Mendaros | Nurse Practitioner | 1809 Wade Hampton Blvd, Suite 120, Greenville, SC 29609-4041 | 2016-01-14 |
| 1093187734 | Bonnie Sue Kennedy | Nurse Practitioner | 1809 Wade Hampton Blvd, Suite 120, Greenville, SC 29609-4041 | 2015-10-21 |
| 1669843843 | Erin Kennedy Johnson | Nurse Practitioner | 1809 Wade Hampton Blvd, Suite 120, Greenville, SC 29609-4041 | 2015-10-13 |
| 1427310853 | Andrew Jay Burgess | Internal Medicine | 1809 Wade Hampton Blvd, Suite 120, Greenville, SC 29609-4041 | 2012-06-12 |
| 1760772537 | Elizabeth Mccoy Mckinney | Internal Medicine | 1809 Wade Hampton Blvd, Suite 120, Greenville, SC 29609-4041 | 2011-04-14 |
| 1285651042 | Daniel Borkert | Family Medicine | 1809 Wade Hampton Blvd, Suite 120, Greenville, SC 29609-4050 | 2006-07-17 |
| 1740207406 | University Medical Associates, LLC | Internal Medicine | 1809 Wade Hampton Blvd, Greenville, SC 29609-4041 | 2006-07-17 |
| 1992756100 | Jean Kimi Saito | Internal Medicine | 1809 Wade Hampton Blvd, Suite 120, Greenville, SC 29609-4041 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326522376 | Piney Mountain Rx LLC | Pharmacy | 2498 North Pleasantburg Drive, Suite A, Greenville, SC 29609 | 2018-09-17 |
| 1417434655 | Kathryn Dorothy Muschick | Pediatrics | 900 W. Faris Dr., Greenville, SC 29609 | 2018-07-20 |
| 1942705645 | The Wright Home Care, LLC | Social Worker | 217 E Stone Ave Ste 8, Greenville, SC 29609 | 2018-03-26 |
| 1205388386 | Galina Hufstetler | Physical Therapist | 414 Summit Drive, Apt. 313, Greenville, SC 29609 | 2016-10-25 |
| 1811303225 | Cal Jones LLC | Pharmacy | 961 Montebello Dr, Suite 2, Greenville, SC 29609 | 2014-07-07 |
| 1982954319 | John C Shaughnessy | Pharmacist | 1141 State Park Road, Greenville, SC 29609 | 2012-09-13 |
| 1770842726 | Neil S Sondov | Counselor | 1100 Rutherford Road, Greenville, SC 29609 | 2012-05-11 |
| 1790044915 | Crystal Ervin | Counselor | 1 Chick Springs Rd Ste 210a, Greenville, SC 29609 | 2012-05-08 |
| 1881992840 | Cherrydale Dental Associates, LLC | Dentist | 105 State Park Rd, Greenville, SC 29609 | 2011-03-01 |
| 1649584483 | Paul E Waters | Pharmacist | 1 East Stone Ave, Greenville, SC 29609 | 2010-08-04 |
| Find all providers in zip 29609 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609380278 | Sarah Rider Grubbs | Pediatrics | 58 Park Vista Way, Greenville, SC 29617-7939 | 2017-11-18 |
| 1679005409 | Shailesh Manandhar | Pediatrics | 2816 Holly Glen Dr Apt A, Greenville, NC 27834-0064 | 2017-03-30 |
| 1114377645 | Madison Leigh Merritt | Pediatrics | 415 Duncan Chapel Rd, Greenville, SC 29617-8224 | 2016-06-15 |
| 1699139089 | Hunter Utkov Altman | Pediatrics | 701 Grove Road/ob Residency, Greenville, SC 29605-4210 | 2016-04-11 |
| 1851771976 | Ranjith Kasanagottu | Pediatrics | 200 Patewood Dr # A, Greenville, SC 29615-3593 | 2015-06-03 |
| 1336551365 | Sarah Rose Mangum Needham | Pediatrics | 709 Chesapeake Pl, Greenville, NC 27858-6236 | 2014-05-26 |
| 1124466164 | Katherine Marie Richardson | Pediatrics | 200 Patewood Drive Suite A200, Greenville, SC 29615-3580 | 2013-06-12 |
| 1689916264 | Shannon Nicole James | Pediatrics | 703 Verdae Blvd, Greenville, SC 29607 | 2013-03-21 |
| 1346411592 | Smithfield Pediatrics | Pediatrics | 7 Smith Avenue, Suite 103, Greenville, RI 02828 | 2008-03-16 |
| 1558546366 | Childrens Community Care | Pediatrics | 90 Shenango St Ste 12, Greenville, PA 16125-2060 | 2007-12-31 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29609 |
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| 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.