SHANE ASHLEY CORREA (NPI# 1255801189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255801189 |
| Entity Type | Individual |
| Full Name | SHANE ASHLEY CORREA |
| Credential | NP |
| Practice Address |
1000 S Beckham Ave Tyler TX 75701-1908 |
| Mailing Address |
Po Box 130549 Tyler TX 75713-0549 |
| Practice Telephone | 9035905611 |
| Practice Fax Number | 9035356884 |
| Mailing Telephone | 9035793931 |
| Mailing Fax Number | 9035095835 |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2018-12-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP139832 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1000 S BECKHAM AVE |
| City | TYLER |
| State | TX |
| Zip Code | 75701-1908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740280510 | Aleksandra Olsson-detwiler | Internal Medicine | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2005-07-22 |
| 1831706431 | Kalana Sanders | Registered Nurse | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2020-09-28 |
| 1992333975 | Graceanne M. Dimon | Physical Therapist | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2020-03-27 |
| 1760021976 | Gerardo Tapia Hernandez | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2020-01-06 |
| 1861950057 | Brittany Mason Ferguson | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2019-03-06 |
| 1174000962 | David Matthew Burkland | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-07-24 |
| 1598251209 | Kelsey Rene Morton | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-07-05 |
| 1063915916 | Tyler Regional Hospital LLC | Surgery | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-03-16 |
| 1437650264 | Tyler Regional Hospital LLC | Nurse Anesthetist, Certified Registered | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-02-27 |
| 1407364847 | Tyler Regional Hospital LLC | General Acute Care Hospital | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-01-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891329728 | Rachel E Fouse | Nurse Practitioner | 323 S Fannin Ave, Tyler, TX 75702-7321 | 2020-02-29 |
| 1942845243 | Nicolette Jane Silverio | Nurse Practitioner | 6116 Wilshire Dr, Tyler, TX 75703-4160 | 2019-11-10 |
| 1679116610 | Tiffiney Mcmakin | Nurse Practitioner | 810 E Houston St # 100, Tyler, TX 75702 | 2019-10-22 |
| 1356996573 | Katy Sutton | Nurse Practitioner | 1901 Belmont Dr, Tyler, TX 75701-4338 | 2019-08-05 |
| 1063067577 | Elnora King | Nurse Practitioner | 1600 Rice Rd Apt 1117, Tyler, TX 75703-3308 | 2019-08-02 |
| 1851959472 | Tx Np Health, Pllc | Nurse Practitioner | 21755 Syrah Ln, Tyler, TX 75703-9274 | 2019-05-29 |
| 1114482569 | Carolyn Johnson | Nurse Practitioner | 13462 Hwy 110 N, Tyler, TX 75704-2444 | 2019-02-08 |
| 1720543556 | Kelsey Danielle Sheeley | Nurse Practitioner | 6770 Old Jacksonville Hwy Ste 103, Tyler, TX 75703-0576 | 2019-02-06 |
| 1790257392 | Tiffany Yvette Gardner | Nurse Practitioner | 301 Fm 757, Tyler, TX 75705-4503 | 2018-12-20 |
| 1174023352 | Jonathan Brice King | Nurse Practitioner | 721 Clinic Dr # A, Tyler, TX 75701-2043 | 2018-02-14 |
| Find all providers in TYLER | ||||
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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.