MS. SHANNON JOAN CLARK


Address: 3604 Bush St, Raleigh, NC 27609-7511
Phone: 9198767807

MS. SHANNON JOAN CLARK (NPI# 1508299777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1508299777
Entity Type Individual
Full Name MS. SHANNON JOAN CLARK
Credential AGNP RN
Practice Address 3604 Bush St
Raleigh
NC 27609-7511
Mailing Address 3031 New Bern Ave
Ste 306
Raleigh
NC 27610-2989
Practice Telephone 9198767807
Practice Fax Number 9198768823
Mailing Telephone 9192313966
Mailing Fax Number 9192313912
Enumeration Date 2013-08-12
Last Update Date 2020-02-24
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner 235157 NC Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
1700 Tarboro St W, Suite 103, Wilson, NC 278933481 2522939898

Other Providers SHANNON CLARK

NPI Name Taxonomy Address Enumeration
1366931552 Shannon Clark Registered Nurse 8201 S 61st St, Lincoln, NE 68516-5994 2018-05-03
1457786675 Shannon Clark Occupational Therapy Assistant 860 W 132nd Ave, Spc 268, Westminster, CO 80234-1499 2013-09-06
1881726271 Shannon Denise Clark Nurse Practitioner 2 Easton Oval Ste 450, Columbus, OH 43219-6035 2007-03-12
1760537617 Shannon Renee Clark Nurse Practitioner 3128 Santa Rita Rd, Suite C, Pleasanton, CA 94566-8300 2007-01-23
1700940855 Shannon Jackie Clark Contractor 10750 S Knoll Crest Ln, Tucson, AZ 85706-9052 2006-12-21
1720089311 Shannon Lynn Clark Chiropractor 423 Main St, Reinbeck, IA 50669-1049 2005-08-03
1487149373 Shannon Clark Counselor 90 Hospital Dr, Athens, OH 45701-2301 2018-06-25
1679021448 Shannon Lorraine Clark Speech-Language Pathologist 2251 E Paris Ave Se, Grand Rapids, MI 49546-2431 2016-09-21
1770916033 Shannon M Clark Specialist/Technologist, Other 3 Maryland Farms Ste 200, Brentwood, TN 37027-5780 2013-08-09
1700147436 Shannon Clark Day Training/Habilitation Specialist 200 General St, Batesville, AR 72501-9407 2012-05-29

Office Location

Street Address 3604 BUSH ST
City RALEIGH
State NC
Zip Code 27609-7511

Providers in the same location

NPI Name Taxonomy Address Enumeration
1891797049 Wake Nephrology Associates, P.a. Specialist 3604 Bush St, Raleigh, NC 27609-7511 2005-06-01
1770901993 Sarah Mistrot Physician Assistant 3604 Bush St, Raleigh, NC 27609-7511 2014-04-03
1568718336 Nanci Jacqulyn Sullivan-blackert Nurse Practitioner 3604 Bush St, Raleigh, NC 27609-7511 2012-07-31
1699069948 Robert Edward Olivo Internal Medicine 3604 Bush St, Raleigh, NC 27609-7511 2011-06-03
1679885107 Lori Michelle Haskins Nurse Practitioner 3604 Bush St, Raleigh, NC 27609-7511 2010-07-13
1376602391 Deborah B Berg Dietitian, Registered 3604 Bush St, Raleigh, NC 27609-7511 2006-12-06
1780796508 Bio-medical Applications of North Carolina, Inc. Clinic/Center 3604 Bush St, Raleigh, NC 27609-7511 2006-08-31
1386752228 Jacqueline Suzanne Sebastian Nurse Practitioner 3604 Bush St, Raleigh, NC 27609-7511 2006-08-29
1366470791 Donna Antonia Theodore Physician Assistant 3604 Bush St, Raleigh, NC 27609-7511 2006-06-28
1689612442 Jessica J Oneill Physician Assistant 3604 Bush St, Raleigh, NC 27609-7511 2006-06-03
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1184235582 Choice Service Solutions LLC In Home Supportive Care 5300 Six Fox Rd Siite205, Raleigh, NC 27609 2020-08-11
1003426073 Rosana Oba -rovira Registered Nurse 5300 Six Fox Road, Suite 205, Raleigh, NC 27609 2020-08-05
1821612706 Helen Alexandra Bonner Physical Medicine & Rehabilitation Hey Clinic Pa, 3320 Wake Forest Road Ste 450, Raleigh, NC 27609 2020-06-05
1215423579 Appiah Nana Larbi Social Worker Easter Seals Ucp 4000 Wake Forest Rd Ste 200, Raleigh, NC 27609 2018-07-10
1215423777 Broadway Home Care LLC In Home Supportive Care 107 Windel Dr Ste 105, Raleigh, NC 27609 2018-07-09
1275027948 Lacey Allene Cottingham Social Worker 312 W Millbrook Rd Ste 129, Raleigh, NC 27609 2018-06-18
1447748819 Integrated Dermatology of North Raleigh, Pllc Dermatology 3809 Computer Dr Ste 200, Raleigh, NC 27609 2018-05-01
1902325418 Naomi Christine Askew Nurse Practitioner 3400 Wake Forest Drive, Bldg 9, Bldg #9, 4th Floor, Raleigh, NC 27609 2017-09-15
1962929679 Alexia Montague Social Worker 1306 Paddock Drive Suite E-100, Raleigh, NC 27609 2017-08-23
1730602236 Chantel Washington-mbuthia Counselor 1100 Logger Ct. Ste C100, Heartfelt Alternative Inc, Raleigh, NC 27609 2017-07-18
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1902406671 Lilly Danielle Appleberry Nurse Practitioner 6005 Clarks Fork Dr, Raleigh, NC 27616-5821 2020-10-30
1891318739 Christopher Paul Murphy Nurse Practitioner 11200 Governor Manly Way Ste 23, Raleigh, NC 27614-8599 2020-05-27
1669095139 Shannon Yahyapour Nurse Practitioner 1528 Shadowood Ln, Raleigh, NC 27612-5917 2020-05-19
1134752181 Pamela Liane Harris Claxton Nurse Practitioner 3708 San Pablo Dr, Raleigh, NC 27616-4540 2020-02-18
1083253033 Brenda Lee Gartrell Nurse Practitioner 2000 Red Quartz Dr, Raleigh, NC 27610-5634 2019-12-21
1154979227 Bethany Bartholomew Nurse Practitioner 10941 Raven Ridge Rd Ste 201, Raleigh, NC 27614-6487 2019-08-30
1831750181 Becky L Milam Nurse Practitioner 5900 Six Forks Rd Ste 200, Raleigh, NC 27609-8226 2019-06-27
1275034357 Matthew O'donnell Nurse Practitioner 6500 Creedmoor Rd Ste 110, Raleigh, NC 27613-3698 2018-02-23
1356852792 Meredith Tschoke Nurse Practitioner 4505 Falls of Neuse Rd Ste 650, Raleigh, NC 27609-2523 2017-10-12
1992174775 Chun Young Hong Nurse Practitioner 3414 Six Forks Rd., Raleigh, NC 27609 2015-09-22
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Competitor

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City RALEIGH
Zip Code 27609

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Dataset Information

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.

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