ROGER B SHAMBO, MD, LLC (NPI# 1215133491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215133491 |
| Entity Type | Organization |
| Organization Name | ROGER B SHAMBO, MD, LLC |
| Practice Address |
9732 State Route 12 Copenhagen NY 13626-0026 |
| Mailing Address |
9732 State Route 12 Po Box 26 Copenhagen NY 13626-0026 |
| Practice Telephone | 3156882305 |
| Practice Fax Number | 3156882139 |
| Mailing Telephone | 3156882305 |
| Mailing Fax Number | 3156882139 |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ROGER B SHAMBO (OWNER) |
| Authorized Official Telephone | 3156882305 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 165521 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
9732 STATE ROUTE 12 |
| City | COPENHAGEN |
| State | NY |
| Zip Code | 13626-0026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649251489 | Roger Brian Shambo | Family Medicine | 9732 State Route 12, Copenhagen, NY 13626-2906 | 2005-11-09 |
| 1871881649 | Laurel J Shambo | Physician Assistant | 9732 State Route 12, Copenhagen, NY 13626-2906 | 2011-07-14 |
| 1376529651 | Norman Bruce Scott | Family Medicine | 9732 State Route 12, Copenhagen, NY 13626-2906 | 2005-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487159125 | Tonya Jean Farrell | Licensed Practical Nurse | 9860 Nys Rt 12, Apt 2, Copenhagen, NY 13626 | 2018-03-26 |
| 1316003023 | Copenhagen Central School | Local Education Agency (LEA) | 3020 Mechanic Street, Copenhagen, NY 13626 | 2006-12-28 |
| 1780003889 | Corey Ameele | Chiropractor | 101 School Street, Copenhagen, NY 13626-0162 | 2014-04-16 |
| 1609013218 | Mary K Greene | Speech-Language Pathologist | 2988 Cataract St., Copenhagen, NY 13626-0286 | 2009-01-20 |
| 1235749979 | Lewis County General Hospital | Clinic/Center | Copenhagen Health Center, 9732 State Route 12, Copenhagen, NY 13626-1362 | 2020-08-07 |
| 1619510799 | Kristine Baker | Marriage & Family Therapist | 10138 Washington St, Copenhagen, NY 13626-2814 | 2019-10-22 |
| 1710367891 | Melinda Iketau | Counselor | 9502 State Route 12, Apt 3, Copenhagen, NY 13626-2904 | 2015-06-04 |
| 1639590821 | Rachel L Slate | Licensed Practical Nurse | 14858 Odell Rd, Copenhagen, NY 13626-3175 | 2013-12-15 |
| 1982176327 | Jennifer Ercle Gardner | Registered Nurse | 391 Denning Rd, Copenhagen, NY 13626-3403 | 2018-12-26 |
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649251489 | Roger Brian Shambo | Family Medicine | 9732 State Route 12, Copenhagen, NY 13626-2906 | 2005-11-09 |
| 1376529651 | Norman Bruce Scott | Family Medicine | 9732 State Route 12, Copenhagen, NY 13626-2906 | 2005-12-19 |
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|---|---|---|---|---|
| 1881295558 | Mamoon Malik | Family Medicine | 90 Menands Rd, Albany, NY 12204-1400 | 2020-11-08 |
| 1336749571 | Chowdhury Medical PC | Family Medicine | 155 Alkier St, Brentwood, NY 11717-5129 | 2020-10-27 |
| 1356940084 | Rebecca Jean Smouse | Family Medicine | 1107 Prendergast Ave, Jamestown, NY 14701-3315 | 2020-10-23 |
| 1336748136 | Rapha House Calls | Family Medicine | 2 Fernglade Ct, Chester, NY 10918-2637 | 2020-10-22 |
| 1174122980 | Richmond Health Partners Ipa LLC | Family Medicine | 1161 Victory Blvd, Staten Island, NY 10301-3621 | 2020-10-22 |
| 1730787128 | Michael C Secallus | Family Medicine | 66 Kirkwood Gdns, Kirkwood, NY 13795-1623 | 2020-10-16 |
| 1861099053 | Julia Gross Family Health Nurse Practitioner, Pllc | Family Medicine | 950 Route 146 Ste 100, Clifton Park, NY 12065-3667 | 2020-10-01 |
| 1013523190 | Steinway Hope Medical LLC | Family Medicine | 8829 54th Ave Fl 2, Elmhurst, NY 11373-4543 | 2020-09-23 |
| 1538774500 | Jenny Brandt | Family Medicine | 3048 Sunset Ln # 2, Schenectady, NY 12303-5528 | 2020-09-15 |
| 1992319016 | Sarah Glaser | Family Medicine | 30 W 24th St, New York, NY 10010-3207 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
| City | COPENHAGEN |
| Zip Code | 13626 |
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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.