SHANNON CHRISTINE ROBERTS (NPI# 1396797239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396797239 |
| Entity Type | Individual |
| Full Name | SHANNON CHRISTINE ROBERTS |
| Other Name | SHANNON CHRISTINE LUIS |
| Credential | MD FACOG |
| Practice Address |
555 E Broadway Ave Ste 108 Jackson WY 83001-8640 |
| Mailing Address |
Po Box 1844 Jackson WY 83001-1844 |
| Practice Telephone | 3077341005 |
| Practice Fax Number | 3077341165 |
| Mailing Telephone | 3077341005 |
| Mailing Fax Number | 3077341165 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2012-12-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 6698A | WY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 117467300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528623691 | Shannon Monique Roberts | Behavior Technician | 6148 Passionate Ct, N Las Vegas, NV 89031-3538 | 2019-05-04 |
| 1215496005 | Shannon Ann Roberts | Behavior Technician | 432 West St, Gaylord, MI 49735-8301 | 2019-03-19 |
| 1235306119 | Shannon Roberts | Chiropractor | 3786 S East St, Indianapolis, IN 46227-1241 | 2008-05-10 |
| 1629286869 | Shannon Nicole Roberts | Technician | 1813 Flinthill Dr, Columbus, OH 43223-3542 | 2007-05-20 |
| 1780742916 | Shannon Orlando Roberts | Respite Care | 3657 S Double Echo Rd, Tucson, AZ 85735-5132 | 2006-12-04 |
| 1255374880 | Shannon Leigh Roberts | Nurse Practitioner | 7744 Conner Rd, Powell, TN 37849-3509 | 2006-06-13 |
| 1578182101 | Shannon Leigh Roberts | Chiropractor | 11 E Calhoun St, Sumter, SC 29150-4315 | 2020-04-14 |
| 1073174215 | Shannon Roberts | Behavior Technician | 4196 Douglas Blvd, Granite Bay, CA 95746-5904 | 2019-06-27 |
| 1467817072 | Shannon Roberts | Specialist | 175 Burdette St, Spartanburg, SC 29307-1003 | 2015-12-24 |
| 1740535814 | Shannon Dobelbower Roberts | Dentist | 559 Vincent St Bldg 959, Peterson Afb, CO 80914-1541 | 2012-07-16 |
| Street Address |
555 E BROADWAY AVE STE 108 |
| City | JACKSON |
| State | WY |
| Zip Code | 83001-8640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336124890 | Angus G Goetz IIi | Orthopaedic Surgery | 555 E Broadway Ave, Jackson, WY 83001-8640 | 2005-12-07 |
| 1013403013 | Devyn K Parnes | Physician Assistant | 555 E Broadway Ave, Jackson, WY 83001-8640 | 2018-07-03 |
| 1447785829 | Nola Peacock | Physical Therapist | 555 E Broadway Ave, Suite 113, Jackson, WY 83001-8640 | 2017-04-24 |
| 1609323302 | Calvin P Schenk | Physician Assistant | 555 E Broadway Ave, Suite 201, Jackson, WY 83001-8640 | 2016-09-09 |
| 1194196667 | Sarah J Peterson | Dietitian, Registered | 555 E Broadway Ave, Ste 201, Jackson, WY 83001-8640 | 2015-10-09 |
| 1679994933 | Lindsay Katherine Love | Physical Therapist | 555 E Broadway Ave, Jackson, WY 83001-8640 | 2014-01-03 |
| 1588005193 | Cara Anne Sengebush | Physical Therapist | 555 E Broadway Ave, Jackson, WY 83001-8640 | 2013-07-11 |
| 1336588672 | Mountain Therapy Pllc | Counselor | 555 E Broadway Ave, Suite 216, Jackson, WY 83001-8640 | 2013-06-20 |
| 1376895169 | Patricia Drui | Speech-Language Pathologist | 555 E Broadway Ave, Suite 100, Jackson, WY 83001-8640 | 2012-10-04 |
| 1982955001 | Carol Bocker | Speech-Language Pathologist | 555 E Broadway Ave, Suite 100, Jackson, WY 83001-8640 | 2012-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861006108 | Anne Kathleen Milburn | Physical Therapist | 3620 S Park Drive, Jackson, WY 83001 | 2020-09-03 |
| 1568009637 | Katherine Pringle Ford | Case Manager/Care Coordinator | 2065 E. Limber Pine Road, Jackson, WY 83001 | 2019-12-07 |
| 1043878408 | Cossette Burnham | Physical Therapist | Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 | 2019-05-31 |
| 1982169371 | Cynthia Buck Huyffer | Social Worker | 755a Cache Creek Drive, Jackson, WY 83001 | 2019-02-10 |
| 1093281594 | Lara Cilo | Speech-Language Pathologist | 1300 W. Valley Springs Road, Jackson, WY 83001 | 2018-10-23 |
| 1740776202 | Teton Oral and Maxillofacial Surgery | Dentist | 1160 Alpine Ln Ste 1d, Jackson, WY 83001 | 2018-07-09 |
| 1437642055 | Anna Yanchek | Physical Therapist | 1090 Us- 89, Jackson Hole, WY 83001 | 2018-06-08 |
| 1891200762 | Tyler Ross Wright | Chiropractor | 1325 Us-89, Suite 108, Jackson, WY 83001 | 2017-12-13 |
| 1073027280 | Root To Rise Counseling and Consulting, Pllc | Social Worker | 2033 Dandelion Court, Jackson, WY 83001 | 2017-11-27 |
| 1962923912 | Piper Worthington | Social Worker | 1910 High School Rd, Jackson, WY 83001 | 2017-06-29 |
| Find all providers in zip 83001 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528477007 | Shandeidra Nicole Bonds-singleton | Obstetrics & Gynecology | 657 Skyline Dr Dept Of, Jackson, TN 38301-3903 | 2014-08-08 |
| 1477995454 | Camille Stephanie Mellijor-figg | Obstetrics & Gynecology | 430 S Cache St, Jackson, WY 83001-8692 | 2013-07-19 |
| 1245535392 | River Oaks Management Company, LLC | Obstetrics & Gynecology | 1860 Hospital Dr, Suite 103, Jackson, MS 39204-3410 | 2011-01-21 |
| 1134374291 | Joy Luck | Obstetrics & Gynecology | 2009 W Michigan Ave, Jackson, MI 49202-4010 | 2008-11-17 |
| 1720241532 | Henry Earl West | Obstetrics & Gynecology | 657 Skyline Dr Ste B, Jackson, TN 38301-3903 | 2008-07-02 |
| 1649432626 | William Ashley Hood D.o. | Obstetrics & Gynecology | 1020 River Oaks Dr Ste 430, Jackson, MS 39232-9500 | 2008-06-30 |
| 1790956837 | Jackson Ob-gyn Plc | Obstetrics & Gynecology | 306 W Washington, Ste 102, Jackson, MI 49201 | 2008-03-17 |
| 1295863611 | Richard Nmi Ignatius | Obstetrics & Gynecology | 23 Conor Rd, Jackson, NJ 08527-3781 | 2007-02-28 |
| 1902941768 | Jackson Healthcare for Women Pa | Obstetrics & Gynecology | 1047 N Flowood Dr, Jackson, MS 39232-9533 | 2007-02-20 |
| 1689747396 | Shore Point Obstetrics & Gynecology, P.C. | Obstetrics & Gynecology | 22 Linda Dr, Jackson, NJ 08527-5026 | 2006-11-17 |
| Find all providers in JACKSON | ||||
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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.