SHANNON K IDZIK (NPI# 1467445924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467445924 |
| Entity Type | Individual |
| Full Name | SHANNON K IDZIK |
| Other Name | SHANNON K REEDY |
| Credential | CRNP |
| Practice Address |
655 W Lombard St 345 Baltimore MD 21201-1512 |
| Practice Telephone | 4107068129 |
| Practice Fax Number | 4107060344 |
| Mailing Telephone | 4107068129 |
| Mailing Fax Number | 4107060344 |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2011-01-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
R131534 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
655 W LOMBARD ST 345 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21201-1512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982918926 | Susan Marie Antol | Registered Nurse | 655 W Lombard St, Suite 425b, Baltimore, MD 21201-1512 | 2010-08-02 |
| 1518182468 | Carol Snapp | Advanced Practice Midwife | 655 W Lombard St, Baltimore, MD 21201-1512 | 2007-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585470 | Meshref Ayed Alshehri | Student in an Organized Health Care Education/Training Program | 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-07-08 |
| 1306462411 | Michael Julian Wong | Student in an Organized Health Care Education/Training Program | University of Maryland, Department of Anesthesiology, 22 S Green St, S11b, Baltimore, MD 21201 | 2020-06-24 |
| 1740817733 | Martha Kaitlyn Coghlan | Student in an Organized Health Care Education/Training Program | Ummc Ob/gyn, 22 S. Greene St., Baltimore, MD 21201 | 2020-03-27 |
| 1629606637 | Taylor Renee Kai | Student in an Organized Health Care Education/Training Program | University of Maryland, 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-03-27 |
| 1295362697 | Brittany A Oster | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street 6th Floor, Suite 300, Baltimore, MD 21201 | 2020-03-25 |
| 1346877735 | Kayvon Michael Mobarakeh | Student in an Organized Health Care Education/Training Program | University of Maryland Department of Anesthesiology, 22 S Greene St, S11c, Baltimore, MD 21201 | 2020-03-25 |
| 1598392284 | Zachary Allan Hagen | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street, 6th Flr., Suite 200, Baltimore, MD 21201 | 2020-03-24 |
| 1700430055 | Jaime Semchuk | Student in an Organized Health Care Education/Training Program | 737 West Lombard, Baltimore, MD 21201 | 2019-07-25 |
| 1952861619 | Zachary Daniel Sanford | Student in an Organized Health Care Education/Training Program | 22 S Greene Street S8b12, Baltimore, MD 21201 | 2019-03-20 |
| 1114487840 | Spencer Sykes Lovegrove | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street, Sixth Floor, Suite 200, Baltimore, Sixth Floor, Suite 200, Baltimore, MD 21201 | 2019-03-20 |
| Find all providers in zip 21201 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598364192 | Folasade O Onasanya | Nurse Practitioner | 3312 Croydon Rd, Baltimore, MD 21207-4543 | 2020-10-23 |
| 1437785706 | Hajia M Nagaiya | Nurse Practitioner | 3525 Courtleigh Dr, Baltimore, MD 21244-2205 | 2020-03-19 |
| 1730654062 | Alaina Lourdes Frey | Nurse Practitioner | 3455 Wilkens Ave # L10, Baltimore, MD 21229-5213 | 2018-10-13 |
| 1336624113 | Optimum Family Clinic | Nurse Practitioner | 6014 Harford Rd, Baltimore, MD 21214-1327 | 2018-09-27 |
| 1538687140 | E & T Healthcare Enterprise | Nurse Practitioner | 8113 Hartford Road, Baltimore, MD 21234 | 2017-09-04 |
| 1447791058 | Elizabeth Richmond | Nurse Practitioner | 2 East Wells Apt 179, Baltimore, MD 21230 | 2017-03-15 |
| 1073050365 | Marla Brown | Nurse Practitioner | 6821 Reisterstown Rd Ste 106, Baltimore, MD 21215-1434 | 2017-01-24 |
| 1326443086 | Yury Malachevsky | Nurse Practitioner | 2435 W. Belvedere Avenue, Suite 22, Baltimore, MD 21215 | 2014-10-23 |
| 1174954499 | Neighborhood Wellness, LLC | Nurse Practitioner | 2401 Liberty Heights Avenue, Mondawmin Mall, Space 4625, Baltimore, MD 21215-8086 | 2013-12-12 |
| 1811261050 | Ashley Miller Salamone | Nurse Practitioner | 1800 Orleans Street Sheikh Zayed Tower, Suite 7125 F-1, Baltimore, MD 21287-0020 | 2012-03-06 |
| Find all providers in BALTIMORE | ||||
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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.