MR. PATRICK DEWAYNE SHANNON (NPI# 1396028171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396028171 |
| Entity Type | Individual |
| Full Name | MR. PATRICK DEWAYNE SHANNON |
| Practice Address |
110 E Creighton Ave Fort Wayne IN 46803-3344 |
| Mailing Address |
6219 Wilmarbee Dr Fort Wayne IN 46804-1543 |
| Practice Telephone | 2604561841 |
| Mailing Telephone | 2604335409 |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2011-09-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 26018335A | IN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245582717 | Patrick Shannon | Physician Assistant | 319 S Manning Blvd Ste 304, Albany, NY 12208-1744 | 2012-10-09 |
| 1184937682 | Patrick Shannon | Dentist | 1692 Massachusetts Ave, Cambridge, MA 02138-1878 | 2010-07-26 |
| 1700020567 | Patrick Shannon | Dentist | 3150 E 41st St, Tulsa, OK 74105-3717 | 2009-04-23 |
| 1528090172 | Patrick Robert Shannon | Emergency Medicine | 835 Hospital Road, Emergency Department, Indiana, PA 15701-0788 | 2006-07-06 |
| 1538157433 | Patrick J Shannon | Family Medicine | 1200 E Columbia Ave, Colville, WA 99114-3354 | 2005-10-13 |
| 1316933260 | Patrick L. Shannon | Specialist | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2005-09-26 |
| Street Address |
110 E CREIGHTON AVE |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46803-3344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598770638 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 110 E Creighton Ave, Fort Wayne, IN 46803-3344 | 2006-07-29 |
| 1306465570 | Mariah Vasquez | Pharmacist | 110 E Creighton Ave, Fort Wayne, IN 46803-3344 | 2020-04-08 |
| 1093167488 | Ehlimana Hamidovic | Pharmacist | 110 E Creighton Ave, Fort Wayne, IN 46803-3344 | 2016-07-08 |
| 1124301395 | Nelson Ajobodada Metitiri | Pharmacist | 110 E Creighton Ave, Fort Wayne, IN 46803-3344 | 2011-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669811931 | Alyssa Kate Elaine Pierce | Registered Nurse | 3044 Schele Ave, Fort Wayne, IN 46803 | 2013-06-20 |
| 1538188164 | Deanna A Young | Counselor | 2020 East Washington Blvd, Suite 700, Fort Wayne, IN 46803 | 2006-07-18 |
| 1265491211 | Kamie Joy Lucas | Specialist/Technologist | 1600 E Washington Blvd, Indiana Institute of Technology, Fort Wayne, IN 46803 | 2006-03-20 |
| 1164693255 | Aaa Superior, Inc. | Taxi | 1520 E Berry St, Fort Wayne, IN 46803-1001 | 2008-03-17 |
| 1265951255 | Kailen Berry | Specialist/Technologist | 1600 E Washington Blvd, Fort Wayne, IN 46803-1228 | 2017-09-12 |
| 1013453927 | Nathaniel Acree | Specialist/Technologist | 1600 E Washington Blvd, Fort Wayne, IN 46803-1228 | 2017-01-17 |
| 1689784225 | Parkview Hospital | General Acute Care Hospital | 1600 E Washington Blvd, Fort Wayne, IN 46803-1228 | 2006-08-30 |
| 1093774796 | Mcgee-lytle Inc | Psychologist | 2020 E Washington Blvd, Suite 650, Fort Wayne, IN 46803-1327 | 2006-03-21 |
| 1770722878 | Jennifer L Malott | Social Worker | 2020 E Washington Blvd, Suite 700, Fort Wayne, IN 46803-1359 | 2009-02-12 |
| 1356583918 | Angela Robbins Gebert | Durable Medical Equipment & Medical Supplies | 5436 Old Maumee Rd, Unit 1, Fort Wayne, IN 46803-1713 | 2009-03-28 |
| Find all providers in zip 46803 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347102 | Austin Hartzog | Pharmacist | 5110 Value Drive, Fort Wayne, IN 46808 | 2020-08-21 |
| 1528677622 | Leslie Renee Siegel | Pharmacist | 11109 Parkview Plaza Dr # 1, Fort Wayne, IN 46845-1701 | 2020-07-24 |
| 1962048140 | Andrew Quang Tran | Pharmacist | 6202 Saint Joe Center Rd, Fort Wayne, IN 46835-2506 | 2019-11-21 |
| 1467005991 | Nicholas Selby | Pharmacist | 6220 Saint Joe Center Rd, Fort Wayne, IN 46835-2506 | 2019-07-23 |
| 1215427042 | Jerry Eugene Falls | Pharmacist | 9817 Chapmans Blvd, Fort Wayne, IN 46835-9194 | 2018-05-17 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1063900611 | Juliette Peters | Pharmacist | 1900 Carew St Ste 4, Fort Wayne, IN 46805-4765 | 2018-04-30 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1790238350 | Karleen Goodwin | Pharmacist | 3964 New Vision Dr, Fort Wayne, IN 46845-1712 | 2016-08-01 |
| 1699131300 | Brent Alan Losier | Pharmacist | 3537 N Anthony Blvd, Suite A, Fort Wayne, IN 46805-1423 | 2016-01-11 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46803 |
Please comment or provide details below to improve the information on MR. PATRICK DEWAYNE SHANNON.
| 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.