SHANNON M FOGARTY (NPI# 1508801622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508801622 |
| Entity Type | Individual |
| Full Name | SHANNON M FOGARTY |
| Other Name | SHANNON M WHITAKER |
| Credential | N.P. |
| Practice Address |
1055 N Mayfair Rd Wauwatosa WI 53226 |
| Mailing Address |
1055 N Mayfair Rd Wauwatosa WI 53226-3436 |
| Practice Telephone | 4144792300 |
| Mailing Telephone | 4144792300 |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2018-07-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 1545-033 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 43917700 | 05 | |
| WI | MEDICARE RAILROAD | 500014946 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518261924 | Shannon Fogarty | Occupational Therapist | 3050 Brown Ave, Mount Dora, FL 32757-3453 | 2010-12-28 |
| Street Address |
1055 N MAYFAIR RD |
| City | WAUWATOSA |
| State | WI |
| Zip Code | 53226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356797609 | Khyati Soni | Family Medicine | 1055 N Mayfair Rd, Wauwatosa, WI 53226-3436 | 2016-05-05 |
| 1255772190 | Savan Panchal | Family Medicine | 1055 N Mayfair Rd, Wauwatosa, WI 53226-3436 | 2013-07-08 |
| 1487999074 | Beth E. Stay | Nurse Practitioner | 1055 N Mayfair Rd, Wauwatosa, WI 53226-3436 | 2012-12-07 |
| 1114287513 | Daniel Molinaro | Family Medicine | 1055 N Mayfair Rd, Wauwatosa, WI 53226-3436 | 2012-05-21 |
| 1871804757 | Dheeraj Reddy | Internal Medicine | 1055 N Mayfair Rd, Wauwatosa, WI 53226 | 2010-06-25 |
| 1801127386 | Aurora Advanced Healthcare, Inc. | Non-Pharmacy Dispensing Site | 1055 N Mayfair Rd, Wauwatosa, WI 53226-3436 | 2010-01-22 |
| 1689860132 | Oncology Alliance, S.c. | Internal Medicine | 1055 N Mayfair Rd, Wauwatosa, WI 53226-3436 | 2007-09-19 |
| 1760531818 | William Shaffer | Family Medicine | 1055 N Mayfair Rd, Wauwatosa, WI 53226-3436 | 2007-01-09 |
| 1447309786 | Mark H Hermanoff | Internal Medicine | 1055 N Mayfair Rd, Wauwatosa, WI 53226-3436 | 2007-01-09 |
| 1417038381 | Sara J Nolan | Family Medicine | 1055 N Mayfair Rd, Wauwatosa, WI 53226-3436 | 2006-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
| 1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
| 1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
| 1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
| 1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
| 1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
| Find all providers in zip 53226 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306443460 | Zhengqi Fan | Nurse Practitioner | 7850 Harwood Ave Unit 3, Wauwatosa, WI 53213-2561 | 2020-10-01 |
| 1578196770 | Suzanne Girard | Nurse Practitioner | 2600 N Mayfair Rd Ste 545, Wauwatosa, WI 53226-1306 | 2020-02-15 |
| 1538723044 | Mh Health Care Services, PC | Nurse Practitioner | 3300 N 124th St # W14, Wauwatosa, WI 53222-3106 | 2019-04-30 |
| 1932682473 | Tracy A Bolton | Nurse Practitioner | 2626 N 76th St Ste 101, Wauwatosa, WI 53213 | 2018-09-11 |
| 1750892113 | Karen Lynn Molitor | Nurse Practitioner | 2600 N. Mayfair Rd. Metropolitan Urology, Suite 545, Wauwatosa, WI 53226 | 2017-10-12 |
| 1255716783 | Baljinder Kaur | Nurse Practitioner | 830 N 109th St Ste 1, Wauwatosa, WI 53226-3754 | 2015-07-27 |
| 1942637921 | Robin Julianne-poedel Simon | Nurse Practitioner | 8320 W Bluemound Rd Ste 125, Wauwatosa, WI 53213-3367 | 2013-10-04 |
| 1437482403 | Monica Teresa Bradtke | Nurse Practitioner | 10000 Blue Mound Rd, Wauwatosa, WI 53226 | 2009-09-09 |
| 1215993555 | Angela M Paul | Nurse Practitioner | 10000 W Blue Mound Rd, Wauwatosa, WI 53226-4321 | 2006-04-25 |
| 1023617214 | Holly C Helm | Nurse Practitioner | 10800 W Capitol Dr, Wauwatosa, WI 53222-1109 | 2020-10-20 |
| Find all providers in WAUWATOSA | ||||
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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.