M SHANE ANGLETON (NPI# 1447280508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447280508 |
| Entity Type | Individual |
| Full Name | M SHANE ANGLETON |
| Credential | P.A. |
| Practice Address |
1801 Black River Blvd N Rome NY 13440-2427 |
| Practice Telephone | 3153373770 |
| Practice Fax Number | 3153377614 |
| Mailing Telephone | 3153373770 |
| Mailing Fax Number | 3153377614 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
003097-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1801 BLACK RIVER BLVD N |
| City | ROME |
| State | NY |
| Zip Code | 13440-2427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730151507 | Gibran Tallim | Family Medicine | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2006-02-06 |
| 1164083259 | Mona Lisa Smith | Nurse Practitioner | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2019-06-27 |
| 1174017297 | Diane P Clute | Nurse Practitioner | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2018-06-21 |
| 1245781467 | Patricia Jacqualine Zupan | Physician Assistant | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2016-10-24 |
| 1275930422 | Olubukola T Adeyeye | Pediatrics | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2014-12-02 |
| 1770816688 | Gulnara Rubinshteyn | Pediatrics | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2009-09-09 |
| 1659506111 | Desmond Francis | Internal Medicine | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2009-05-27 |
| 1093974511 | Reo Malachi Peniston | Family Medicine | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2008-06-09 |
| 1295890143 | Edwin A Vera | Nurse Practitioner | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2006-12-22 |
| 1932118684 | Adrienne Michelle Smith | Physician Assistant | 1801 Black River Blvd N, Rome, NY 13440-2427 | 2006-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801409966 | Jamie Marcinkowski | Nurse Practitioner | 1617 N James Street, Suite 100, Rome, NY 13440 | 2020-08-28 |
| 1205452810 | Nichole Elizabeth Pollard | Optometrist | 1320 Floyd Ave, Suite 1, Rome, NY 13440 | 2020-06-19 |
| 1235750662 | Nicole Schrader | Social Worker | 7214 Bunal Blvd, Rome, NY 13440 | 2020-04-27 |
| 1457908212 | Darlene A. Sherman | Technician | 101 Glen Road S., Rome, NY 13440 | 2019-08-26 |
| 1841846847 | Delores A Smith | Technician | 7374 Davis Road, Rome, NY 13440 | 2019-08-15 |
| 1609342807 | Kent A Myers | Occupational Therapist | 200 West Dominic St, Rome, NY 13440 | 2018-10-16 |
| 1013376870 | Bonnie Flansburg | Physical Therapy Assistant | 101 W Liberty Street, Rome, NY 13440 | 2016-02-22 |
| 1760888689 | Ashley Elizabeth Bloomquist | Pharmacist | 808 West Chestnut Street, Rome, NY 13440 | 2014-11-05 |
| 1902231483 | Stephanie Ostalkiewicz | Licensed Practical Nurse | 701 Camp Street, Rome, NY 13440 | 2013-09-04 |
| 1992142251 | Tammy S. Guiliano | Registered Nurse | 401 Turin Street, The New York State School for The Deaf, Rome, NY 13440 | 2013-05-28 |
| Find all providers in zip 13440 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801402888 | Meredith Gaines | Physician Assistant | 603 W 1st St Unit 1, Rome, GA 30161-3067 | 2020-09-16 |
| 1639153810 | Leone P Cordle | Physician Assistant | 126 Three Rivers Dr Ne, Rome, GA 30161-4999 | 2005-12-01 |
| 1124636527 | Alan Phrommala | Physician Assistant | 501 Redmond Rd Nw, Rome, GA 30165-1415 | 2020-07-21 |
| 1417371642 | William Brandon Newby | Physician Assistant | 18 Riverbend Dr Sw, Suite 120, Rome, GA 30161-6013 | 2014-02-07 |
| 1639437379 | Staci Robin Graves | Physician Assistant | 715 E 2nd Ave Sw, Rome, GA 30161-6148 | 2012-05-01 |
| 1669559795 | Christina Lyndell Miller | Physician Assistant | 1500 N James St, Rome, NY 13440-2844 | 2006-11-01 |
| 1902999865 | Jeffery Scott Roy | Physician Assistant | 91 Perimeter Rd, Suite 100, Rome, NY 13441-4018 | 2006-10-02 |
| 1336258268 | Gregory Lee Fisher | Physician Assistant | 420 E 2nd Ave, Suite 103, Rome, GA 30161-3209 | 2006-08-30 |
| 1609884196 | Jennifer M Goldbach | Physician Assistant | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2006-08-03 |
| 1093723454 | Henry G. Wood | Physician Assistant | 310 W 10th St Ne, Rome, GA 30165-2639 | 2006-08-03 |
| Find all providers in ROME | ||||
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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.