MS. SHANNON KAY WATERS (NPI# 1538365184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538365184 |
| Entity Type | Individual |
| Full Name | MS. SHANNON KAY WATERS |
| Credential | PA-C |
| Practice Address |
322 Mulberry St Sw Suite A Lenoir NC 28645-5702 |
| Practice Telephone | 8287576460 |
| Practice Fax Number | 8287594901 |
| Mailing Telephone | 8287576460 |
| Mailing Fax Number | 8287594901 |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2016-11-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 101692 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | STATE LICENSE | 101692 | 01 |
| NC | STATE NURSING LICENSE | 081159 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831739796 | Shannon Marie Waters | Counselor | 1275 Nw Adams St Ste C, Mcminnville, OR 97128-3549 | 2020-01-08 |
| 1023598927 | Shannon Faye Waters | Psychologist | 101 T St Ne, Washington, DC 20002-1519 | 2018-08-20 |
| 1538452099 | Shannon Waters | Speech-Language Pathologist | 2701 N Rocky Point Dr Ste 650, Tampa, FL 33607-5999 | 2011-05-17 |
| 1093861916 | Shannon Marie Waters | Counselor | 503 E 23rd St S, Independence, MO 64055-1502 | 2007-01-25 |
| Street Address |
322 MULBERRY ST SW SUITE A |
| City | LENOIR |
| State | NC |
| Zip Code | 28645-5702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992768766 | Mark Richard Brady | Internal Medicine | 322 Mulberry St Sw, Suite A, Lenoir, NC 28645-5702 | 2006-04-11 |
| 1023504685 | Emily Combs | Nurse Practitioner | 322 Mulberry St Sw, Lenoir, NC 28645-5702 | 2018-07-07 |
| 1104355775 | Samuel James Hester | Audiologist | 322 Mulberry St Sw, Lenoir, NC 28645-5702 | 2017-06-07 |
| 1407380504 | Mari Lee | Nurse Practitioner | 322 Mulberry St Sw, Lenoir, NC 28645-5702 | 2017-04-14 |
| 1215310081 | Emma Barnard | Audiologist | 322 Mulberry St Sw, Suite C, Lenoir, NC 28645-5702 | 2015-06-29 |
| 1871830679 | Caldwell Memorial Hospital, Inc. | Internal Medicine | 322 Mulberry St Sw, Suite G, Lenoir, NC 28645-5702 | 2013-01-14 |
| 1588943278 | Caldwell Memorial Hospital, Inc. | Internal Medicine | 322 Mulberry St Sw, Suite A, Lenoir, NC 28645-5702 | 2011-08-11 |
| 1700184470 | Caldwell Memorial Hosptial, Inc | Audiologist | 322 Mulberry St Sw, Suite C, Lenoir, NC 28645-5702 | 2011-03-04 |
| 1417178591 | Ruihai Zhou | Internal Medicine | 322 Mulberry St Sw, Suite F, Lenoir, NC 28645-5702 | 2007-05-02 |
| 1861553950 | Charles Larry Lutz | Internal Medicine | 322 Mulberry St Sw, Suite A, Lenoir, NC 28645-5702 | 2006-12-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477174597 | Healthstat Onsite Clinic Mccreary Modern Plant 6 | Preventive Medicine | 2961 Rocky Road, Lenoir, NC 28645 | 2020-04-29 |
| 1912485780 | Brandi Fitzgerald Newell | Nurse Practitioner | 902 Kirkwood Street Nw, Lenoir, NC 28645 | 2018-08-02 |
| 1568911345 | Kimberly Fletcher | Physical Therapist | 1031 Morganton Blvd. Sw, Lenoir, NC 28645 | 2016-09-22 |
| 1093115743 | Dana May Yang | Pharmacist | 875 Blowing Road Blvd, Lenior, NC 28645 | 2014-08-31 |
| 1659780542 | Brinkley & Associates of Lenoir | Dentist | 230 Morganton Boulevard Sw, Lenoir, NC 28645 | 2014-08-05 |
| 1194148858 | Cheryl Ann Simpson | Contractor | 7951 Rocky Knob Rd, Lenoir, NC 28645 | 2014-01-30 |
| 1013266048 | Mccreary Cancer Center | Clinic/Center | 212 Mulberry Street Sw, Lenoir, NC 28645 | 2012-09-06 |
| 1356651145 | Anthony Kwasi Essien | Pharmacist | 102 Harper Ave., Lenoir, NC 28645 | 2010-10-14 |
| 1033344866 | Thomas J Young | Surgery | 401 Mulberry Street, Sw, Suite 202, Lenoir, NC 28645 | 2009-05-22 |
| 1821238155 | Mark C Kammer | Physical Therapist | 1041 Morganton Blvd, Ste 200, Lenoir, NC 28645 | 2009-02-26 |
| Find all providers in zip 28645 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811402951 | Jonathan Rowland Smith | Physician Assistant | 322 Mulberry St Sw Ste C, Lenoir, NC 28645-5703 | 2017-12-12 |
| 1790123743 | Derek A Boyer | Physician Assistant | 322 Mulberry St Sw Ste A, Lenoir, NC 28645-5703 | 2013-06-12 |
| 1184718199 | Kathleen M Lappin | Physician Assistant | 1208 Hickory Blvd Sw Ste 102, Lenoir, NC 28645-6461 | 2006-10-03 |
| 1033163159 | Scott Edward Fox | Physician Assistant | 1041 Morganton Blvd Sw Ste 100, Lenoir, NC 28645-5605 | 2006-05-22 |
| 1710940739 | Suzanne N. Dapo | Physician Assistant | 1041 Morganton Blvd Sw, Suite 101, Lenoir, NC 28645-5605 | 2006-04-10 |
| 1538783915 | Caldwell Memorial Hospital, Inc. | Physician Assistant | 321 Mulberry St Sw, Lenoir, NC 28645-5720 | 2020-06-02 |
| 1811481948 | Matthew Taylor Yelverton | Physician Assistant | 232 Sharon Ave Nw, Lenoir, NC 28645-4326 | 2018-06-21 |
| 1053833277 | Geoffrey Wayne Wright | Physician Assistant | 321 Mulberry St Sw, Lenoir, NC 28645-5720 | 2017-07-10 |
| 1437523099 | Jeffrey D Price | Physician Assistant | 232 Sharon Ave Nw, Lenoir, NC 28645-4326 | 2015-11-19 |
| 1083094304 | Stephanie M. Chambers | Physician Assistant | 1208 Hickory Blvd Sw Ste 102, Lenoir, NC 28645-6461 | 2015-06-02 |
| Find all providers in LENOIR | ||||
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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.