SHANNON KORICH (NPI# 1528465986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528465986 |
| Entity Type | Individual |
| Full Name | SHANNON KORICH |
| Credential | ANP |
| Practice Address |
55 Lake Ave N Worcester MA 01655-0002 |
| Mailing Address |
107 Lincoln St Worcester MA 01605-2401 |
| Practice Telephone | 5083343850 |
| Practice Fax Number | 5083345623 |
| Mailing Telephone | 5084533028 |
| Mailing Fax Number | 5084533107 |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2020-09-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
RN269272 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
55 LAKE AVE N |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556587 | James E Liebmann | Internal Medicine | 55 Lake Ave N, Hematology/oncology, Worcester, MA 01655-0002 | 2005-05-23 |
| 1518568732 | Justin Bullard | Psychologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-11-04 |
| 1346849825 | Meghan Moore | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-26 |
| 1174122899 | Jessica Goncalves Ferreira | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-23 |
| 1235746686 | Desiree Mytych | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-29 |
| 1659986248 | Rebecca Lynn Harris | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-10 |
| 1639781487 | Gabriella Kathleen Holland | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-21 |
| 1730791898 | Kerry Anne Benedict | Speech-Language Pathologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1902418999 | Natasha R. Turner | Genetic Counselor, MS | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1144830712 | Abbey Corsini | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205489713 | Darryl Sweeper Jr. | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Psychiatry, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-23 |
| 1225690530 | Ryan Zenevitch | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Family Medicine, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-08 |
| 1932688454 | Victoria Sayeg | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Pediatrics, Worcester, MA 01655 | 2018-08-07 |
| 1114425675 | Judith Dio Wentzell | Social Worker | Umassmemorial Medical Center, 55 Lake Ave North, Dept of Care Coordination, Worcester, MA 01655 | 2018-01-30 |
| 1861927386 | Muhammad Waqas Khan | Student in an Organized Health Care Education/Training Program | University of Massachusetts 55 North Lake Ave, Neurology, Worcester, MA 01655 | 2017-04-21 |
| 1861806192 | Qaiser Shamshir Khan | Psychiatry & Neurology | 55 Lake Ave N # S7-831, Worcester, MA 01655 | 2014-06-14 |
| 1073858981 | Heidi Glover | Nurse Practitioner | 55 Lake Ave North Dept. of Pedi-adolescent, Ummc University Campus, Worcester, MA 01655 | 2012-12-04 |
| 1972867992 | Anna Bjornsdottir | Psychiatry & Neurology | 55 Lake Av N, Worcester, MA 01655 | 2012-06-25 |
| 1245567676 | Steven Edward Mckinley | Nurse Practitioner | 55 Lake Ave. North, Umass Memorial Medical Center University Campus, Worcester, MA 01655 | 2009-11-05 |
| 1851582951 | Robin I Davidson | Neurological Surgery | 55 Lake Ave, North, Ummhc-univ Campus, Worcester, MA 01655 | 2007-08-05 |
| Find all providers in zip 01655 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033576574 | Denise Rugg | Nurse Practitioner | 100 Research Dr, Worcester, MA 01605-4312 | 2016-01-27 |
| 1649604133 | Beth Waithira Harden | Nurse Practitioner | 16 Edgeworth St, Worcester, MA 01605-3224 | 2013-09-03 |
| 1861734030 | Jillian Julia Russell | Nurse Practitioner | 939 Southbridge St, Worcester, MA 01610-2227 | 2013-03-26 |
| 1386907541 | Jeanne Marie Snow | Nurse Practitioner | 691 Grafton St, Worcester, MA 01604-3185 | 2012-06-21 |
| 1164525028 | Lisa Catherine Gaimari | Nurse Practitioner | 486 Chandler Street, Worcester State College, Student Health Services, Worcester, MA 01602 | 2006-09-06 |
| 1467555607 | Lori Williams | Nurse Practitioner | 486 Chandler St # G209, Worcester State College Student Health Services, Worcester, MA 01602-2861 | 2006-09-06 |
| 1073595047 | Ruth Remington | Nurse Practitioner | 630 Plantation St, Worcester, MA 01605-2038 | 2005-11-16 |
| 1073158721 | Adam D Bliss | Nurse Practitioner | 162 Chandler St, Worcester, MA 01609-2924 | 2019-11-16 |
| 1578045498 | Shadie Bajrami | Nurse Practitioner | 26 Queen St, Worcester, MA 01610-2473 | 2018-09-06 |
| 1427576453 | Amanda Murray | Nurse Practitioner | 416 Belmont St, Worcester, MA 01604-1086 | 2017-08-30 |
| Find all providers in WORCESTER | ||||
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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.