DR. SHANNON BERRY (NPI# 1205253267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205253267 |
| Entity Type | Individual |
| Full Name | DR. SHANNON BERRY |
| Credential | M.D. |
| Practice Address |
3181 Sw Sam Jackson Park Rd Portland OR 97239-3011 |
| Practice Telephone | 5034947500 |
| Practice Fax Number | 5034944997 |
| Mailing Telephone | 5034948211 |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | MD173846 | OR | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2111 Exchange St, Astoria, OR 971033329 | 5034948211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720401714 | Shannon D. Berry | Speech-Language Pathologist | 1231 Harbor River Dr, Memphis, TN 38103-8980 | 2014-01-27 |
| 1922141555 | Shannon Lee Jett Berry | Speech-Language Pathologist | 218 N Florida St, Suite 3, Bushnell, FL 33513-6150 | 2007-02-14 |
| 1679174643 | Shannon Berry | Pharmacist | 1712 E Ohio St, Clinton, MO 64735-2402 | 2020-11-05 |
| 1295057818 | Shannon Berry | Occupational Therapy Assistant | 420 Gaffney Dr, Watertown, NY 13601-1823 | 2010-02-23 |
| 1770719668 | Shannon Gammill Berry | Emergency Medicine | 1635 Marvel St, Coushatta, LA 71019-9022 | 2009-06-05 |
| 1649381245 | Shannon Berry | Advanced Practice Midwife | 100 Brewster Blvd, Medical Staff Services, Camp Lejeune, NC 28547-2538 | 2006-08-31 |
| 1013909811 | Shannon M Berry | Internal Medicine | 295 Posada Ln, Suite D, Templeton, CA 93465-4055 | 2005-08-17 |
| Street Address |
3181 SW SAM JACKSON PARK RD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97239-3011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972506301 | Jerris Robert Hedges | Emergency Medicine | 3181 Sw Sam Jackson Park Rd, # L-102, Portland, OR 97239-3011 | 2005-05-31 |
| 1114528486 | Nathan Stencel | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3098 | 2020-11-04 |
| 1073113064 | Evan Mitchell | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-28 |
| 1629678834 | Vanessa Davie | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-27 |
| 1952901480 | Jackie Kim Sharpe | Pharmacist | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-26 |
| 1922607530 | Leah Snyder | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3098 | 2020-10-23 |
| 1932708740 | Blake Beneville | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3098 | 2020-10-22 |
| 1154920833 | Isabelle Nguyen | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-22 |
| 1124627054 | Musah N Iddrisu | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-21 |
| 1386242105 | Wenelia Baghoomian | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
| 1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
| 1881219657 | Desiree Baer | Licensed Vocational Nurse | Sw Us Veterans Hospital Rd, Portland, OR 97239 | 2020-06-08 |
| 1285266205 | Melissa Irene Wheeler | Registered Nurse | Uhs-8l, 3181 S.w. Sam Jackson Park Road, Portland, OR 97239 | 2020-02-07 |
| 1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
| 1801448063 | Alice Huang Huang | Student in an Organized Health Care Education/Training Program | 3710 Sw Veterans Road, Portland, OR 97239 | 2019-07-09 |
| 1710446273 | Ellen Noreen Kessi | Social Worker | 3710 Sw Us Veterans Rd., Portland, OR 97239 | 2019-03-14 |
| 1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
| 1275030926 | Carly Elizabeth Dougher | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 | 2018-04-10 |
| 1780188094 | Dennis John Samuel | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239 | 2018-03-21 |
| Find all providers in zip 97239 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376074674 | Samuel B Potter | Emergency Medicine | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2017-03-27 |
| 1912361718 | Bryce Edwards | Emergency Medicine | 3181 Sw Sam Jackson Park Road, Ohsu, Portland, OR 97239 | 2016-04-07 |
| 1073907978 | Karen Ta | Emergency Medicine | 10300 Se Main St, Portland, OR 97216 | 2015-03-27 |
| 1104210921 | Elizabeth Hatfield | Emergency Medicine | 3181 Sw Sam Jackson Park Rd # Cdw, Portland, OR 97239-3011 | 2015-03-19 |
| 1699171918 | Stephen Boyer | Emergency Medicine | 3708 Sw Lyle Ct, Portland, OR 97221-3963 | 2014-11-13 |
| 1679991590 | Meaghan Dehning | Emergency Medicine | 3181 Sw Sam Jackson Park Rd # Em, Portland, OR 97239-3011 | 2014-03-29 |
| 1942647185 | Jason F Hine | Emergency Medicine | E1 Clairmont Ct, Portland, ME 04103-4459 | 2013-05-29 |
| 1487900742 | Aaron Vitells | Emergency Medicine | 2424 Ne 41st Ave, Portland, OR 97212-5423 | 2012-07-24 |
| 1073870895 | Marcus Alyn Chiodo | Emergency Medicine | 10000 Se Main St Ste 40, Adventist Medical Center - The Pavilion, Portland, OR 97216-2461 | 2012-04-18 |
| 1184913147 | Jerry L Lawrence | Emergency Medicine | 11705 Nw Timberview Ln, Apt 204, Portland, OR 97229-6659 | 2011-03-30 |
| Find all providers in PORTLAND | ||||
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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.