SHANNON MEDICAL CENTER (NPI# 1336386028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336386028 |
| Entity Type | Organization |
| Organization Name | SHANNON MEDICAL CENTER |
| Other Organization Name | SHANNON MEDICAL CENTER - OUTPATIENT DIALYSIS FACILITY |
| Practice Address |
2018 Pulliam St San Angelo TX 76905-5148 |
| Mailing Address |
Po Box 1879 San Angelo TX 76902-1879 |
| Practice Telephone | 3256536741 |
| Mailing Telephone | 3256536741 |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2011-08-26 |
| Authorized Official Name | MISS PATRICIA KIRKHAM (BILLING SUPERVISOR) |
| Authorized Official Telephone | 3256575031 |
| Is Organization Subpart | Y |
| Parent Organization Name | SHANNON MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
00168 | TX | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 148371103 | 05 |
| Other Name | Type Code |
|---|---|
| Shannon Medical Center - Outpatient Dialysis Facility | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730211533 | Shannon Medical Center | Ambulance | 120 E Harris, San Angelo, TX 76903 | 2007-03-09 |
| 1225031446 | Shannon Medical Center | Home Health | 2030 Pulliam St, Ste 6, San Angelo, TX 76905-5157 | 2005-05-23 |
| 1699016337 | Shannon Medical Center | Clinic/Center | 2008 Nine Rd, Brady, TX 76825-7210 | 2013-03-05 |
| 1013977784 | Shannon Medical Center | Psychiatric Hospital | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2006-03-25 |
| 1992765663 | Shannon Medical Center | Chronic Disease Hospital | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2006-03-25 |
| 1235199084 | Shannon Medical Center | Psychiatric Unit | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2006-03-24 |
| 1114987963 | Shannon Medical Center | Skilled Nursing Facility | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2006-03-24 |
| 1306806153 | Shannon Medical Center | Rehabilitation Unit | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2006-03-24 |
| 1104886969 | Shannon Medical Center | Clinic/Center | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2006-03-24 |
| 1992707228 | Shannon Medical Center | General Acute Care Hospital | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2005-05-31 |
| Street Address |
2018 PULLIAM ST |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76905-5148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588646392 | Shannon Joint Ventures, Inc | Internal Medicine | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2005-11-17 |
| 1508369034 | Greg W Anderson | Nurse Practitioner | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2018-03-12 |
| 1881118693 | Fresenius Kidney Care Concho Valley, LLC | Clinic/Center | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2017-08-02 |
| 1184815342 | Susan C Wilkinson | Clinical Nurse Specialist | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2007-08-05 |
| 1003951245 | David Nichols | Emergency Medicine | 2018 Pulliam St, San Angelo, TX 76905 | 2007-02-21 |
| 1457368367 | Glen Michael Mcferren | Psychiatry & Neurology | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2006-08-02 |
| 1447279351 | Rangarao Chilukuri | Internal Medicine | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2006-07-19 |
| 1710913280 | Jackson Todd Achilles | Psychiatry & Neurology | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2006-06-24 |
| 1235199084 | Shannon Medical Center | Psychiatric Unit | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2006-03-24 |
| 1114987963 | Shannon Medical Center | Skilled Nursing Facility | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2006-03-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639437197 | Richard Yeaton Burnell | Registered Nurse | 2018 Bus Us Highway 67-j, San Angelo, TX 76905 | 2012-05-02 |
| 1568752053 | Lucy Jo Smith | Counselor | 2710 Smith Blvd., San Angelo, TX 76905 | 2011-04-18 |
| 1821204587 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 2706 Watson Street, San Angelo, TX 76905 | 2007-05-16 |
| 1770688103 | Alan Keith Carson | Counselor | 218 Pulliam St., San Angelo, TX 76905 | 2006-09-13 |
| 1851992515 | Stacie A Gregg | Nurse Practitioner | 1229 Johnny Ln, San Angelo, TX 76905-2331 | 2020-11-07 |
| 1417340910 | Leslie Ann Rendon | Contractor | 1213 Rita Cir, San Angelo, TX 76905-4201 | 2015-03-09 |
| 1972925295 | Carlos Robledo | Pharmacist | 2626 Smith Blvd, San Angelo, TX 76905-4285 | 2014-01-07 |
| 1376163501 | Megan Elizabeth Barnum | Registered Nurse | 1231 Rita Cir, San Angelo, TX 76905-4292 | 2020-04-17 |
| 1225031446 | Shannon Medical Center | Home Health | 2030 Pulliam St, Ste 6, San Angelo, TX 76905-5157 | 2005-05-23 |
| 1285845214 | Shannon Health Sys Pharmacy Pap | Pharmacy | 2030 Pulliam St Ste 16, San Angelo, TX 76905-5170 | 2007-05-24 |
| Find all providers in zip 76905 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699046771 | Tumalo Dialysis LLC | Clinic/Center | 3518 Knickerbocker Rd, San Angelo, TX 76904-7611 | 2012-01-20 |
| 1952589665 | Angelo Kidney Connection, Pllc | Clinic/Center | 2901 Sherwood Way, Suite 100, San Angelo, TX 76901-3586 | 2008-02-05 |
| 1881118693 | Fresenius Kidney Care Concho Valley, LLC | Clinic/Center | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2017-08-02 |
| 1609860485 | West Texas Renal Care Center Inc | Clinic/Center | 3501 Executive Dr, San Angelo, TX 76904-6883 | 2005-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942801931 | Usrc Mckinney, LLC | Clinic/Center | 1434 N Central Expy Ste 116, Mckinney, TX 75070-3108 | 2020-11-05 |
| 1437756772 | Usrc Bluebonnet, LLC | Clinic/Center | 1902 Windsor Pl, Ste 100, Fort Worth, TX 76110-1866 | 2020-10-08 |
| 1609473941 | Usrc Bluebonnet Home, LLC | Clinic/Center | 1902 Windsor Pl Ste 202, Fort Worth, TX 76110-1866 | 2020-10-08 |
| 1982210050 | Usrc Stephenville LLC | Clinic/Center | 942 Bluebonnet Dr, Stephenville, TX 76401-1764 | 2020-09-23 |
| 1801402979 | Usrc Garland LLC | Clinic/Center | 219 W Kingsley Rd Ste 316, Garland, TX 75041-3434 | 2020-09-23 |
| 1003422171 | Usrc Dialysis At Home West LLC | Clinic/Center | 12011 State Highway 151 Ste 222, San Antonio, TX 78251-1230 | 2020-09-23 |
| 1477165462 | Fresenius Medical Care South Lewisville, LLC | Clinic/Center | 101 E Southwest Pkwy Ste 110, Lewisville, TX 75067-8753 | 2020-08-20 |
| 1598383259 | Dialysis Clinic Inc. | Clinic/Center | 6146 Wurzbach Road, San Antonio, TX 78238 | 2020-07-09 |
| 1891312559 | Usrc Houston Newco Home LLC | Clinic/Center | 2000 Crawford St Ste 777, Houston, TX 77002-9006 | 2020-06-29 |
| 1427671502 | Usrc Plano Dexter, LLC | Clinic/Center | 4708 Dexter Dr, Plano, TX 75093-5288 | 2020-05-22 |
| Find all providers with the same taxonomy | ||||
| City | SAN ANGELO |
| Zip Code | 76905 |
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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.