CHARLENE SHALLOW (NPI# 1295819688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295819688 |
| Entity Type | Individual |
| Full Name | CHARLENE SHALLOW |
| Credential | N.P. |
| Practice Address |
619 E Mason St Ste 4p57 Springfield IL 62701-1034 |
| Practice Telephone | 2177880706 |
| Practice Fax Number | 2175252535 |
| Mailing Telephone | 2177880706 |
| Mailing Fax Number | 2175252535 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2019-05-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
209.005660 | IL | Allopathic & Osteopathic Physicians |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209-005660 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
619 E MASON ST STE 4P57 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62701-1034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720070238 | Neil J. Thomas | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 619 E Mason St Ste 4p57, Springfield, IL 62701 | 2005-08-19 |
| 1588187397 | Andrea Nicole Bloodworth | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701 | 2017-07-24 |
| 1992227417 | Megan D Siegrist | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701-1034 | 2017-07-17 |
| 1518405588 | Waleed Alharbi | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701-1034 | 2017-02-09 |
| 1346653656 | Kevin Alexander Graham | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 619 E Mason St Ste 4p57, Springfield, IL 62701-1034 | 2014-06-04 |
| 1700134087 | Nadia El Hangouche | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701-1034 | 2012-08-17 |
| 1982969960 | Arti Singh | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701-1034 | 2012-07-06 |
| 1801159264 | Jennifer Davis | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701-1034 | 2012-06-20 |
| 1346539467 | Mark Jung-ching Shen | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701 | 2011-03-29 |
| 1619278074 | Wesley Brian Zwiefel | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701-1034 | 2010-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687183 | Affinity Patient Coordination LLC | In Home Supportive Care | 217 E Monroe St Ste 102, Springfield, IL 62701 | 2018-07-31 |
| 1427498435 | Donald L Jacoby | Pharmacist | 701 N. First St., Springfield, IL 62701 | 2013-07-05 |
| 1700183480 | Erin Zepp | Dietitian, Registered | 319 E Madison St Ste 1f, Springfield, IL 62701 | 2011-02-16 |
| 1518117159 | Jyoti Assudani | Pediatrics | 301 N 8th Street, Springfield, IL 62701 | 2008-09-19 |
| 1396924148 | Jeanne Lyn Malone | Counselor | 408 South Fifth Street, Springfield, IL 62701 | 2007-10-29 |
| 1942422928 | Nobuharu Harada | Family Medicine | 301 N 8th, Pav-3a158, Springfield, IL 62701 | 2007-05-02 |
| 1427131127 | Radiological Associates of Decatur | Radiology | 319 E Madison Suite J, Springfield Mri & Imaging Center, Springfield, IL 62701 | 2006-10-24 |
| 1669498606 | Independence Holding Co LLC | Pharmacy | 201 North 5th Street, Springfield, IL 62701 | 2006-07-14 |
| 1174075147 | Loralee Donnelly | Nurse Practitioner | 301 N 8th St, Springfield, IL 62701 | 2016-10-26 |
| 1871945725 | Ashley R Bell | Nurse Practitioner | 319 E Madison St Ste 1f, Springfield, IL 62701 | 2016-07-04 |
| Find all providers in zip 62701 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669072823 | Rachel Westbrook | Nurse Practitioner | 1417 Burning Bush Ct, Springfield, IL 62712-7529 | 2020-10-27 |
| 1730786377 | Catherine Newman | Nurse Practitioner | 27124 La-42, Springfield, LA 70462 | 2020-10-07 |
| 1275146268 | Courtney Wilbern | Nurse Practitioner | 1200 W Centre St, Springfield, IL 62704-5812 | 2020-08-28 |
| 1588276240 | Andrew Ronald Mouser | Nurse Practitioner | 607 Prospect Rd, Springfield, PA 19064-2819 | 2020-08-23 |
| 1821609082 | William Coleman Bryant | Nurse Practitioner | 5552 W Longleaf Dr, Springfield, MO 65802-7834 | 2020-08-12 |
| 1386254399 | Ashley Lynn Murray | Nurse Practitioner | 2443 E Greenwood St, Springfield, MO 65804-3907 | 2020-08-04 |
| 1679182281 | Erica Gail Hunt | Nurse Practitioner | 2813 Haverford Rd, Springfield, IL 62704-4267 | 2020-07-29 |
| 1063020063 | Gage Azeez | Nurse Practitioner | 46 Timber Ln, Springfield, MA 01119-2828 | 2020-07-16 |
| 1033737440 | Janne L Nicholson | Nurse Practitioner | 8360 Dunham Ct Apt G, Springfield, VA 22152-1122 | 2020-07-13 |
| 1922623156 | Amanda E Hildebrand | Nurse Practitioner | 3370 Carman Ave, Springfield, IL 62703-4642 | 2020-06-12 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62701 |
Please comment or provide details below to improve the information on CHARLENE SHALLOW.
| 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.