MR. SHANNON LESLIE HERSHBERGER (NPI# 1215173059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215173059 |
| Entity Type | Individual |
| Full Name | MR. SHANNON LESLIE HERSHBERGER |
| Credential | PA-C |
| Practice Address |
923 W 3rd St Pembroke NC 28372-9628 |
| Mailing Address |
2002 N Cedar St Ste B Lumberton NC 28358-3926 |
| Practice Telephone | 9105210564 |
| Practice Fax Number | 9105218091 |
| Mailing Telephone | 9102723048 |
| Mailing Fax Number | 9107383764 |
| Enumeration Date | 2008-12-29 |
| Last Update Date | 2020-11-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0010-01640 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8102131 | 05 |
| Street Address |
923 W 3RD ST |
| City | PEMBROKE |
| State | NC |
| Zip Code | 28372-9628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891794384 | James Earl West | Internal Medicine | 923 W 3rd St, Pembroke, NC 28372-9684 | 2005-07-18 |
| 1689172868 | Tyler Elliott Dial | Physician Assistant | 923 W 3rd St, Pembroke, NC 28372-9628 | 2018-01-23 |
| 1730559790 | Sean Buckley | Nurse Practitioner | 923 W 3rd St, Pembroke, NC 28372 | 2015-10-03 |
| 1104103779 | Christina O Mcmillan | Physical Therapist | 923 W 3rd St, Pembroke, NC 28372-9684 | 2011-11-10 |
| 1760769335 | Carol Locklear | Physical Therapy Assistant | 923 W 3rd St, Pembroke, NC 28372-9684 | 2011-11-10 |
| 1083991657 | Mallory Carter | Physical Therapy Assistant | 923 W 3rd St, Pembroke, NC 28372-9684 | 2011-11-10 |
| 1457637704 | Firsthealth of The Carolinas, Inc. | Clinic/Center | 923 W 3rd St, Firsthealth Center of Rehabilitation-pembroke, Pembroke, NC 28372-9684 | 2011-11-01 |
| 1740417906 | Toni Chagolla Oxendine | Internal Medicine | 923 W 3rd St, Pembroke, NC 28372-9628 | 2009-06-16 |
| 1003082769 | Trinity Urgent Care & Family Practice, Pllc | Clinic/Center | 923 W 3rd St, Suite A, Pembroke, NC 28372-9684 | 2008-05-02 |
| 1770650749 | Denene P. Smith | Nurse Practitioner | 923 W 3rd St, Pembroke, NC 28372-9628 | 2006-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962977 | Kayla J Oxendine | Counselor | 86 Threehunts Drive, Pembroke, NC 28372 | 2020-11-03 |
| 1720688401 | Melissa Claire Kratz | Pharmacist | 930 Hwy 711 East, Pembroke, NC 28372 | 2020-10-30 |
| 1841775681 | Nikki Locklear | Counselor | 86 Three Hunts Dr., Pembroke, NC 28372 | 2018-09-27 |
| 1043703218 | Julie Anne Harrison-swartz | Nurse Practitioner | Uncp Student Health, 113 Hawk Drive, Pembroke, NC 28372 | 2018-06-12 |
| 1134627508 | William Dixon | Specialist/Technologist | One University Drive, Pembroke, NC 28372 | 2018-01-31 |
| 1740796291 | A Primary Choice, Inc. | In Home Supportive Care | 208 Union Chapel Road, Suite D, Pembroke, NC 28372 | 2017-12-20 |
| 1578924130 | William Joshua Johnson | Nurse Practitioner | 3334 Moss Neck Road, Pembroke, NC 28372 | 2016-03-10 |
| 1831560234 | Sungjun Jung | Pharmacist | 930 Nc Hwy 711 E, Pembroke, NC 28372 | 2015-10-12 |
| 1154715027 | Lilly Marie Shorter | Counselor | 86 Three Hunt Drive, Pembroke, NC 28372 | 2015-03-27 |
| 1487046728 | Eye Heart You Home Health, LLC | Public Health or Welfare | 925 University Road, Pembroke, NC 28372 | 2015-02-24 |
| Find all providers in zip 28372 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013286889 | Tamim A Alsaedi | Physician Assistant | 923 West 3rd St., Pembroke, NC 28372 | 2011-12-22 |
| 1407045628 | The Yrogerg Medical Group, P.l.l.c | Physician Assistant | 201 E. Livermore Drive Suite #1, Angel Exchange, Pembroke, NC 28372 | 2007-10-24 |
| 1104854967 | Alex Jonathan Sanderson | Physician Assistant | 307 East Wardell Drive, Pembroke, NC 28372 | 2006-06-29 |
| 1558686220 | Sarah Anne Bell | Physician Assistant | 121 Pembroke St, Pembroke, NH 03275-1311 | 2010-04-06 |
| 1235103326 | Patricia J Vanbrunt | Physician Assistant | 159 W. Railroad Street, Pembroke, GA 31321-0190 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902403884 | Billy Scott II | Physician Assistant | 3000 Rogers Rd Ste 100, Wake Forest, NC 27587-5745 | 2020-10-05 |
| 1982213765 | Michaela Lynne Mcbride | Physician Assistant | 9541 Kings Parade Blvd Unit 107, Charlotte, NC 28273-5819 | 2020-07-28 |
| 1386260347 | Elizabeth Warrington Maiche | Physician Assistant | 113 Montgomery Dr, Saluda, NC 28773-7787 | 2020-06-24 |
| 1831715663 | John Wheary | Physician Assistant | 3233 Austin Ave, New Bern, NC 28562-7084 | 2020-06-17 |
| 1629692439 | Julie Anne Augustine | Physician Assistant | 718 S Green St, Winston Salem, NC 27101-5112 | 2020-06-08 |
| 1659995710 | Kristopher Neal Priddy | Physician Assistant | 405 Forest Hill Dr, Shelby, NC 28150-5520 | 2020-06-04 |
| 1710500558 | Christian Wright Fulenwider | Physician Assistant | 104 Linden St, Morganton, NC 28655-3788 | 2020-05-27 |
| 1366065500 | Lisa Lynn Carder | Physician Assistant | 904 Foxcroft Cir Apt D, Shelby, NC 28152-6868 | 2020-05-22 |
| 1982234282 | Brandon Sorkin | Physician Assistant | 280 Executive Park Drive, Suite 100, Concord, NC 28025-2802 | 2020-01-25 |
| 1245860618 | Robert Maughan | Physician Assistant | 129 Bryce Creek Ln, Fayetteville, NC 28303-4981 | 2020-01-24 |
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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.