DR. SHANNON KELLY (NPI# 1578991790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578991790 |
| Entity Type | Individual |
| Full Name | DR. SHANNON KELLY |
| Credential | PHARM.D. |
| Practice Address |
2792 Lea Lake Rd Blaine TN 37709-5214 |
| Practice Telephone | 8656615752 |
| Mailing Telephone | 8656615752 |
| Enumeration Date | 2013-10-25 |
| Last Update Date | 2013-10-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 6823 | TN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831751262 | Shannon Kathleen Kelly | Physician Assistant | 5800 Central Gardens Way Apt 204, Palm Beach Gardens, FL 33418-4125 | 2019-07-06 |
| 1699268821 | Shannon Marie Kelly | Dentist | 200 N Royal Tower Dr, Irmo, SC 29063 | 2018-06-12 |
| 1144483421 | Shannon Elizabeth Kelly | Counselor | 115 E Costilla St, Colorado Springs, CO 80903-2101 | 2008-07-07 |
| 1457313330 | Shannon Kelly | Psychologist | 6001 Brick Ct, Suite 201, Winter Park, FL 32792-9425 | 2006-04-05 |
| 1619593241 | Shannon Marie Kelly | Registered Nurse | 3400 N Woods Ln, Rogers, AR 72756-6712 | 2020-06-19 |
| 1366929747 | Shannon Kelly | Social Worker | 1400 Vfw Pkwy, West Roxbury, MA 02132-4927 | 2018-07-27 |
| 1679084172 | Shannon Marie Kelly | Speech-Language Pathologist | 900 Washington Ave Ste 602, Waco, TX 76701-1283 | 2017-10-24 |
| 1508306309 | Shannon Kelly | Physician Assistant | 159 E 74th St, Second Floor, New York, NY 10021-3235 | 2017-02-28 |
| 1821535741 | Shannon Kelly | Occupational Therapist | 6960 Destiny Dr Ste 112, Rocklin, CA 95677-2995 | 2017-01-30 |
| 1194172668 | Shannon Allison Kelly | Pharmacist | 226 Se 8th Ave, Hillsboro, OR 97123-4218 | 2016-05-15 |
| Street Address |
2792 LEA LAKE RD |
| City | BLAINE |
| State | TN |
| Zip Code | 37709-5214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750841 | Andrews Physical Therapy - Blaine, LLC | Physical Therapist | 1240 Rutledge Pike, Blaine, TN 37709 | 2020-11-03 |
| 1255801809 | Tara Danielle Atkins | Registered Nurse | 180 Emory Rd, Blaine, TN 37709 | 2018-11-27 |
| 1669891248 | Tammy Gould | Nurse Practitioner | 1066 Rutledge Pike, Blaine, TN 37709 | 2014-04-10 |
| 1295228005 | Wanda Fay White | Nurse Practitioner | 586 Rutledge Pike, Blaine, TN 37709-2314 | 2018-06-07 |
| 1336386440 | Cherokee Health Systems | Psychologist | 880 Rutledge Pike, Blaine, TN 37709-2317 | 2009-01-12 |
| 1851909097 | Rachel Miriam Maskin | Student in an Organized Health Care Education/Training Program | 880 Rutledge Pike, Blaine, TN 37709-2317 | 2020-07-14 |
| 1225680010 | Andrea Maria Gorrondona | Student in an Organized Health Care Education/Training Program | 880 Rutledge Pike, Blaine, TN 37709-2317 | 2019-07-11 |
| 1568022168 | Whitley Paige Nicely | Registered Nurse | 880 Rutledge Pike, Blaine, TN 37709-2317 | 2019-06-17 |
| 1942863915 | Kelley Buell | Nurse Practitioner | 880 Rutledge Pike, Blaine, TN 37709-2317 | 2019-04-16 |
| 1366908717 | Joy Long-taylor | Licensed Practical Nurse | 880 Rutledge Pike, Blaine, TN 37709-2317 | 2019-02-11 |
| Find all providers in zip 37709 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760007918 | Andrea Bistodeau | Pharmacist | 4369 Ball Road Ne, Blaine, MN 55014 | 2020-06-13 |
| 1871008631 | Batool Dawood | Pharmacist | 627 129th Ln Ne, Blaine, MN 55434-3212 | 2017-12-02 |
| 1669927315 | Sonja Gunilla Norden | Pharmacist | 1195 Boblett St, Blaine, WA 98230-4062 | 2016-08-23 |
| 1942655311 | Raphael An Hoang | Pharmacist | 12303 Jefferson St Ne, Blaine, MN 55434-2000 | 2016-05-04 |
| 1093108250 | Julie Keese | Pharmacist | 180 Rutledge Pike, Blaine, TN 37709-2416 | 2015-03-12 |
| 1962822429 | Mowlid Balayah | Pharmacist | 12727 Leyte St Ne, Blaine, MN 55449-6792 | 2014-04-23 |
| 1104101187 | Tyler G Dahlgren | Pharmacist | 2334 119th Ave Ne, Blaine, MN 55449-5412 | 2011-10-20 |
| 1386935898 | Benjamin Li | Pharmacist | 1733 H St, 500, Blaine, WA 98230-5156 | 2011-05-02 |
| 1356461271 | Sharon Kay Thoma | Pharmacist | 8949 University Ave Ne, Kmart Pharmacy, Blaine, MN 55434-8000 | 2007-04-02 |
| 1093316788 | Sia Yang | Pharmacist | 600 County Road 10 Ne, Blaine, MN 55434-2329 | 2020-11-08 |
| Find all providers in BLAINE | ||||
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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.