SHANNON RAE SMITH (NPI# 1437766011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437766011 |
| Entity Type | Individual |
| Full Name | SHANNON RAE SMITH |
| Credential | NP |
| Practice Address |
1102 E Michigan Ave Jackson MI 49201-1802 |
| Mailing Address |
4714 Albion Rd Concord MI 49237-9703 |
| Practice Telephone | 5172057299 |
| Mailing Telephone | 7195343195 |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2020-09-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
4704291706 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568203 | Shannon Smith | Counselor | 99 Huckleberry Ct, Three Bridges, NJ 08887-2109 | 2020-11-08 |
| 1821603267 | Shannon Alexandria Smith | Dietitian, Registered | 20621 Ne 1st Ct, Miami, FL 33179-1702 | 2020-09-12 |
| 1790316040 | Shannon Machelle Smith | Nurse Practitioner | 7705 Happy Hollow Dr, Mint Hill, NC 28227-8518 | 2020-01-27 |
| 1750925392 | Shannon Joy Smith | Nurse Practitioner | 152 Pearson Rd, Greer, SC 29651-7146 | 2019-11-06 |
| 1104308014 | Shannon Lynn Smith | Massage Therapist | 15131 Northville Rd, Plymouth, MI 48170-2548 | 2018-09-06 |
| 1548747181 | Shannon Marie Smith | Psychologist | 146 2nd St N Ste 305, Saint Petersburg, FL 33701-3361 | 2018-07-26 |
| 1942726393 | Shannon Elizabeth Smith | Counselor | 3535 S Sherwood Forest Blvd Ste 227, Baton Rouge, LA 70816-2255 | 2017-08-17 |
| 1043749450 | Shannon Michelle Smith | Marriage & Family Therapist | 707 W 5th Ave Apt 1116, Spokane, WA 99204-2780 | 2017-06-08 |
| 1033640644 | Shannon Elizabeth Smith | Social Worker | 212 W Red Bridge Rd, Kansas City, MO 64114-5136 | 2017-03-24 |
| 1518311240 | Shannon Kathleen Smith | Licensed Practical Nurse | 9040 Jackson Avenue, Attn Mchk-clq-c, Madigan Army Medical Center, Tacoma, WA 98431-1000 | 2016-04-19 |
| Street Address |
1102 E MICHIGAN AVE |
| City | JACKSON |
| State | MI |
| Zip Code | 49201-1802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477509727 | Andrew M Marcin Jr. | Physician Assistant | 1102 E Michigan Ave, Jackson, MI 49201-1802 | 2006-05-26 |
| 1336415272 | Sean Michael Vance | Radiology | 1102 E Michigan Ave, Jackson, MI 49201-1802 | 2012-03-26 |
| 1144410044 | Aleksandar F Dragovic | Radiology | 1102 E Michigan Ave, Jackson, MI 49201-1802 | 2007-07-26 |
| 1942328414 | Annette Elisabeth Kretzler | Specialist | 1102 E Michigan Ave, Jackson, MI 49201-1802 | 2007-03-26 |
| 1619060084 | Julie A Soriano | Radiology | 1102 E Michigan Ave, Jackson, MI 49201-1802 | 2006-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174137863 | Sally Ann Shaw | Behavior Technician | 3699 Miles Rd., Jackson, MI 49201 | 2020-09-01 |
| 1780293043 | Alyn Kristin Kay | Technician | Hope Network-hope's Door Cru, 3699 Miles Rd., Jackson, MI 49201 | 2020-07-23 |
| 1841827946 | Maverick Jubane | Student in an Organized Health Care Education/Training Program | Henry Ford Allegiance Health, 205 N East Avenue, Jackson, MI 49201 | 2020-03-26 |
| 1306486584 | Cody Williams | Technician, Other | 1001 Laurence Avenue St E, Jackson, MI 49201 | 2020-01-15 |
| 1720632292 | Krystie Lynn Adorjan | Speech-Language Pathologist | 1175 W Parnall Rd, Jackson, MI 49201 | 2019-08-01 |
| 1407412653 | Howard Franklin Tanner II | Speech-Language Pathologist | 102 East Michigan Avenue, Jackson, MI 49201 | 2019-05-14 |
| 1356863740 | Rima Zarar Qayyum | Speech-Language Pathologist | 4800 Firethorn Dr., Jackson, MI 49201 | 2017-07-07 |
| 1306384383 | Briana Nesmith | Speech-Language Pathologist | 2025 Ann Arbor Road, Jackson, MI 49201 | 2017-02-09 |
| 1255878062 | W.a. Foote Memorial Hospital, Inc | Otolaryngology | 205 N.east Ave, Jackson, MI 49201 | 2017-01-31 |
| 1306212881 | Aisha Henderson | Social Worker | 729 West Michigan Avenue, Jackson, MI 49201 | 2015-08-19 |
| Find all providers in zip 49201 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952965543 | Sheila Kivali Olira | Nurse Practitioner | 5 Windsong Ct, Jackson, NJ 08527-4081 | 2019-04-29 |
| 1366805608 | Laurie Brown | Nurse Practitioner | 6805 Squaw Creek Rd, Jackson, WY 83001-8888 | 2016-04-04 |
| 1407244171 | Bethesda Health Services, LLC | Nurse Practitioner | 29 N Star Dr Ste D, Jackson, TN 38305-6657 | 2015-01-05 |
| 1245227313 | Susan C Martin | Nurse Practitioner | 1385 S Highland Ave Ste B1, Jackson, TN 38301-7547 | 2005-10-04 |
| 1275189938 | April Terrain Perry | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213 | 2019-08-16 |
| 1801367073 | Careline Palliative Care LLC | Nurse Practitioner | 113 W Michigan Ave Ste 102, Jackson, MI 49201-1340 | 2018-12-16 |
| 1629578273 | Orlesha Carroll Bishop | Nurse Practitioner | 805 E River Pl, Jackson, MS 39202-3486 | 2018-02-20 |
| 1962901587 | Hannah Foreman Ivison | Nurse Practitioner | 2969 Curran Dr N # 200, Jackson, MS 39216 | 2018-02-09 |
| 1598274623 | Allison Leigh Princiotta | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2017-09-20 |
| 1306372925 | Atlas Medical Group, LLC | Nurse Practitioner | 210 N Liberty St, Jackson, TN 38301-6222 | 2017-05-02 |
| 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.