SHANNON LEIGH NICHOLSON (NPI# 1457507717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457507717 |
| Entity Type | Individual |
| Full Name | SHANNON LEIGH NICHOLSON |
| Other Name | SHANNON LEIGH MANGER |
| Credential | CFNP |
| Practice Address |
19455 Deerfield Ave Suite 312 Lansdowne VA 20176-8100 |
| Practice Telephone | 7037295010 |
| Practice Fax Number | 7037295833 |
| Mailing Telephone | 7037295010 |
| Mailing Fax Number | 7037295833 |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2012-06-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024167932 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1457507717 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285042200 | Shannon Norma Nicholson | Social Worker | 75 West St, Danbury, CT 06810-6528 | 2014-07-23 |
| Street Address |
19455 DEERFIELD AVE SUITE 312 |
| City | LANSDOWNE |
| State | VA |
| Zip Code | 20176-8100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174517478 | Scott Michael Sirlin | Pediatrics | 19455 Deerfield Ave, Suite 205, Lansdowne, VA 20176-8100 | 2005-09-01 |
| 1841774601 | Jeylani Gregory Dublin | Physical Medicine & Rehabilitation | 19455 Deerfield Ave, Lansdowne, VA 20176-8100 | 2018-09-18 |
| 1730627860 | Northern Virginia Imaging, LLC | Specialist | 19455 Deerfield Ave, Sutie 102, Lansdowne, VA 20176-8100 | 2017-02-09 |
| 1255886289 | Brittany Starr | Specialist/Technologist | 19455 Deerfield Ave, 312, Lansdowne, VA 20176-8100 | 2016-08-19 |
| 1902281082 | Jeffrey Chase Farnsworth | Physical Therapist | 19455 Deerfield Ave, Suite 309, Lansdowne, VA 20176-8100 | 2015-07-30 |
| 1073994620 | Megan Bureau | Physical Therapist | 19455 Deerfield Ave, Ste 309, Lansdowne, VA 20176-8100 | 2015-06-09 |
| 1447645551 | National Sports Medicine Institute | Clinic/Center | 19455 Deerfield Ave, Suite 309, Lansdowne, VA 20176-8100 | 2015-04-06 |
| 1083008338 | Doctors Choice Home Care Inc | Home Health | 19455 Deerfield Ave, Suite 208, Lansdowne, VA 20176-8100 | 2015-03-25 |
| 1891116059 | Allergy Asthma & Immunology Institute | Allergy & Immunology | 19455 Deerfield Ave, Suite 205, Lansdowne, VA 20176-8100 | 2013-12-13 |
| 1972844918 | Zahra C Ismaeli | Specialist/Technologist | 19455 Deerfield Ave, Suite 312, Lansdowne, VA 20176-8100 | 2013-03-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912923 | Timothy Michael Nixon | Pharmacist | 61 Catoctin Circle, Leesburg, VA 20176 | 2020-11-05 |
| 1558996645 | Stacey E Moran | Occupational Therapist | 44124 Woodrige Parkway, Lansdowne, VA 20176 | 2020-03-09 |
| 1710531272 | Joseph H Kasuska Jr. | Specialist/Technologist | 19455 Deerfield Ave. Suite 306, Lansdowne, VA 20176 | 2019-08-01 |
| 1568935849 | Joel Manalang Polintan Jr. | Physical Therapist | 171 Cedarwalk Circle, Leesburg, VA 20176 | 2019-01-09 |
| 1194203026 | Jing Cao | Acupuncturist | 19450 Deerfield Ave Ste 275, Leesburg, VA 20176 | 2018-08-02 |
| 1134648314 | Alaina Marie Gotwalt | Speech-Language Pathologist | 43850 Heatherstone Terrace, Unit 406, Leesburg, VA 20176 | 2017-09-19 |
| 1841717105 | Happy Inhome Care Corp | Respite Care | 722 E Market St Ste 103, Leesburg, VA 20176 | 2017-08-28 |
| 1912423484 | Aaa Good Healthcare LLC | Nursing Care | 722 East Market Street Ne, Suite 102, Leesburg, VA 20176 | 2017-08-16 |
| 1740704253 | Anna Maria Domingo Seaford | Physician Assistant | 19441 Golf Vista Plz Ste 230, Lansdowne, VA 20176 | 2017-07-27 |
| 1710436480 | Reena Patel | Physician Assistant | 224 Cornwall St Nw Leesburg Orthope, Unit 204, Leesburg, VA 20176 | 2016-09-23 |
| Find all providers in zip 20176 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982076899 | Jennifer Lynn Mendrysa | Nurse Practitioner | 19415 Deerfield Avenue, Suite 112, The Urology Group, Lansdowne, VA 20176 | 2015-10-30 |
| 1194166355 | Natasha Williams | Nurse Practitioner | 5 E Plumstead Ave, Lansdowne, PA 19050-1213 | 2013-07-16 |
| 1225644735 | Shipra S Shah | Nurse Practitioner | 19415 Deerfield Ave Ste 213, Lansdowne, VA 20176-8471 | 2020-09-20 |
| 1629600325 | Tiffany B Turner | Nurse Practitioner | 950 E Baltimore Ave, Lansdowne, PA 19050-2702 | 2020-02-10 |
| 1629628698 | Bahareh Nazemi | Nurse Practitioner | 19490 Sandridge Way Ste 240, Lansdowne, VA 20176-3467 | 2019-09-12 |
| 1720528631 | Renee Wilson | Nurse Practitioner | 19415 Deerfield Ave, Suite 112, Lansdowne, VA 20176-8452 | 2017-02-27 |
| 1710378567 | Lindsay Zastrow Smith | Nurse Practitioner | 19465 Deerfield Ave, Suite 401, Lansdowne, VA 20176-1701 | 2015-02-16 |
| 1023423761 | Shahnoza Mamatova | Nurse Practitioner | 19305 Ruby Dr, Lansdowne, VA 20176-6508 | 2014-06-20 |
| 1942598685 | Stephanie Ruth-strange | Nurse Practitioner | 19415 Deerfield Ave, Suite 213, Lansdowne, VA 20176-8452 | 2011-07-15 |
| 1891024287 | Cynthia Mcfarland | Nurse Practitioner | 19305 Ruby Dr, Lansdowne, VA 20176-6508 | 2009-12-14 |
| Find all providers in LANSDOWNE | ||||
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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.