SHANNON KELLY EVANS (NPI# 1487953675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487953675 |
| Entity Type | Individual |
| Full Name | SHANNON KELLY EVANS |
| Other Name | SHANNON KELLY |
| Practice Address |
4123 Dutchmans Ln Ste 301 Louisville KY 40207-4721 |
| Mailing Address |
111 Colchester Ave Burlington VT 05401-1473 |
| Practice Telephone | 8028472700 |
| Mailing Telephone | (802) 847-2700 |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2017-07-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 042.0012902 | VT | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689187635 | Shannon Nicole Evans | Student in an Organized Health Care Education/Training Program | 9 Brentwood Dr, Jackson, NJ 08527-3417 | 2017-11-13 |
| 1477984599 | Shannon Evans | Social Worker | 78 Salvatore Ct, Elmwood Park, NJ 07407-2436 | 2013-11-30 |
| 1316374655 | Shannon Michelle Evans | Midwife | 1581 Nw 98th Ave, Pembroke Pines, FL 33024-4331 | 2013-10-01 |
| 1003071804 | Shannon D Evans | Family Medicine | 4745 Boardwalk Drive Unit C3, Fort Collins, CO 80525 | 2008-07-22 |
| 1467906578 | Shannon Marie Evans | Physical Therapist | 3767 Delaware Ave, Kenmore, NY 14217-1040 | 2016-08-05 |
| 1649723149 | Shannon Evans | Occupational Therapist | 620 8th Ave, Terre Haute, IN 47804-2744 | 2016-08-01 |
| 1407208242 | Shannon Marie Evans | Nurse Practitioner | 1823 E 7th St, Austin, TX 78702-2713 | 2016-07-05 |
| 1760858351 | Shannon Evans | Speech-Language Pathologist | 2560 Montessouri St, Suite 113, Las Vegas, NV 89117-3061 | 2015-08-18 |
| 1205184488 | Shannon Marie Evans | Optometrist | 1711 Ne 163rd St, North Miami Beach, FL 33162-4732 | 2012-08-21 |
| 1851477574 | Shannon Evans | Physician Assistant | 501 S Poplar St, Elizabethtown, NC 28337-9375 | 2006-10-27 |
| Street Address |
4123 DUTCHMANS LN STE 301 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40207-4721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144298316 | Ketan C Mehta | Pediatrics | 4123 Dutchmans Ln Ste 301, Louisville, KY 40207-4721 | 2006-03-14 |
| 1275167629 | Jennifer L Kiel | Nurse Practitioner | 4123 Dutchmans Ln Ste 301, Louisville, KY 40207-4721 | 2020-02-25 |
| 1710523634 | Emily Michelle Anguiano | Nurse Practitioner | 4123 Dutchmans Ln Ste 301, Louisville, KY 40207-4721 | 2019-11-26 |
| 1063055002 | Synthia Heffernan | Nurse Practitioner | 4123 Dutchmans Ln Ste 301, Louisville, KY 40207-4721 | 2019-10-22 |
| 1003310921 | Stephanie Rae Kelty | Nurse Practitioner | 4123 Dutchmans Ln Ste 301, Louisville, KY 40207 | 2018-03-23 |
| 1235630039 | Kimberly Dawn Walker | Nurse Practitioner | 4123 Dutchmans Ln Ste 301, Louisville, KY 40207-4721 | 2018-02-27 |
| 1013433366 | Mary Kathleen Lanoue | Nurse Practitioner | 4123 Dutchmans Ln Ste 301, Louisville, KY 40207-4721 | 2017-08-18 |
| 1699137729 | Kyle Hawkins | Pediatrics | 4123 Dutchmans Ln Ste 301, Louisville, KY 40207-4721 | 2016-03-28 |
| 1316323900 | Sherri Lynn Lammerding | Nurse Practitioner | 4123 Dutchmans Ln Ste 301, Louisville, KY 40207-4721 | 2015-08-05 |
| 1871910331 | Kayla Nicole Evans-judd | Pediatrics | 4123 Dutchmans Ln Ste 301, Louisville, KY 40207-4721 | 2014-03-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780212688 | Alexia Louise Bodamer | Student in an Organized Health Care Education/Training Program | 142 Chenoweth Lane, Lousiville, KY 40207 | 2020-03-28 |
| 1467918664 | Amy Rock LLC | Counselor | 4010 Dupont Cir Ste 307, Louisville, KY 40207 | 2019-02-13 |
| 1649745191 | Louisville Optometric Center, IIi, Psc | Optometrist | 285 Hubbards Lane, Suite 300, Louisville, KY 40207 | 2018-10-11 |
| 1184137440 | Crimson Dove Counseling Services Inc | Community/Behavioral Health | 214 Breckenridge Ln., Suite 203, Louisville, KY 40207 | 2017-11-09 |
| 1285157586 | Dickerson Family Enterprise, LLC | Non-emergency Medical Transport (VAN) | 4350 Brownsboro Rd., Ste. 110, Louisville, KY 40207 | 2017-07-19 |
| 1578085296 | Cardiovascular Medical Specialists LLC | Surgery | 100 Mallard Creek Rd Ste 150, Louisville, KY 40207 | 2017-07-14 |
| 1932636305 | Devon Turley | Prevention Professional | 1017 Dupont Rd, Suite 1, Louisville, KY 40207 | 2017-05-17 |
| 1285095539 | Emily Schwartz Crouch | Marriage & Family Therapist | 4010 Dupont Circle, Suite 582, Louisville, KY 40207 | 2016-03-15 |
| 1306201280 | A A and Associates Approved Alcohol/drug Program | Counselor | 4006 Dutchmans Lane, Louisville, KY 40207 | 2015-12-21 |
| 1629433693 | Jewish Hospital and St. Mary's Healthcare, Inc. | General Acute Care Hospital | 3290 Dutchmans Lane, Louisville, KY 40207 | 2015-12-17 |
| Find all providers in zip 40207 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306316989 | Jacquee L Mcnear | Pediatrics | 801 Barret Avenue Suite 314, Louisville, KY 40204-1701 | 2018-11-27 |
| 1902292857 | Hayley Redmond | Pediatrics | 571 S Floyd St Ste 332, Louisville, KY 40202 | 2015-04-07 |
| 1770978512 | Michael Bricken | Pediatrics | 760 S Hancock St # B100, Louisville, KY 40203 | 2015-03-30 |
| 1114332236 | Amanda Brian Rogers | Pediatrics | 411 E Chestnut St # Street6, Louisville, KY 40202-1713 | 2014-06-26 |
| 1770900144 | Kathryn Thorne | Pediatrics | 9710 Park Plaza Ave Unit 107, Louisville, KY 40241-2292 | 2014-03-24 |
| 1669717690 | Surjeet Singh Dhanjal | Pediatrics | 1506 Thackeray Dr, Louisville, KY 40205-2410 | 2012-12-03 |
| 1164656443 | Betty Sue Spivack | Pediatrics | 8804 Nottingham Pkwy, Louisville, KY 40222-5217 | 2009-05-14 |
| 1821238528 | James Grant Mumford | Pediatrics | 5100 Commerce Crossings Dr, Louisville, KY 40229-2128 | 2009-02-20 |
| 1033371216 | Jonathan R Malowitz | Pediatrics | 4123 Dutchmans Lane Suite 301, Suburban Medical Plaza 3, Louisville, KY 40207 | 2008-06-27 |
| 1356509954 | Julia Lane Mitchell | Pediatrics | 760 S. Hancock St, B100, Louisville, KY 40203 | 2008-05-30 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40207 |
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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.