SHANNA RUTH ELLIOTT (NPI# 1629458302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629458302 |
| Entity Type | Individual |
| Full Name | SHANNA RUTH ELLIOTT |
| Credential | DO |
| Practice Address |
2055 Kimball Ave Suite 101 Waterloo IA 50702 |
| Practice Telephone | 3192722112 |
| Practice Fax Number | 3192722107 |
| Mailing Telephone | 3192722112 |
| Mailing Fax Number | 3192722107 |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2015-06-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | R-10280 | IA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982134870 | Shanna Lynne Elliott | Physical Therapist | 912 Viking Rd Ste 101, Cedar Falls, IA 50613 | 2017-06-14 |
| Street Address |
2055 KIMBALL AVE SUITE 101 |
| City | WATERLOO |
| State | IA |
| Zip Code | 50702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689671653 | John E Sutherland | Family Medicine | 2055 Kimball Ave, Suite 101, Waterloo, IA 50702-5047 | 2005-07-05 |
| 1093332389 | Myriam Jacynthe Donovitch | Family Medicine | 2055 Kimball Ave, Suite 101, Waterloo, IA 50702 | 2020-07-02 |
| 1396200580 | Joanna Hodder | Pharmacist | 2055 Kimball Ave, Waterloo, IA 50702-5014 | 2019-02-01 |
| 1912363524 | Kathleen Mcnamara | Pharmacist | 2055 Kimball Ave, Waterloo, IA 50702-5014 | 2016-01-12 |
| 1457737470 | Emily O'brien | Pharmacist | 2055 Kimball Ave, Waterloo, IA 50702-5014 | 2015-07-31 |
| 1255716809 | Danielle Alexandra Davenport | Family Medicine | 2055 Kimball Ave, Suite 101, Waterloo, IA 50702-5047 | 2015-07-24 |
| 1063896298 | Brett Douglas Van Kley | Family Medicine | 2055 Kimball Ave, Suite 101, Waterloo, IA 50702-5047 | 2015-07-17 |
| 1417331646 | Alexander Wawer | Family Medicine | 2055 Kimball Ave, Suite 101, Waterloo, IA 50702-5047 | 2015-07-17 |
| 1235513466 | Eric Roychowdhury | Family Medicine | 2055 Kimball Ave, Suite 101, Waterloo, IA 50702-5047 | 2015-07-17 |
| 1053794305 | Cortney Catherine Corson | Nurse Practitioner | 2055 Kimball Ave, 340, Waterloo, IA 50702 | 2015-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684709 | Peoples Community Health Clinic, Inc | Clinic/Center | 425 1/2 East Ridgeway Ave., Waterloo, IA 50702 | 2020-09-23 |
| 1346867439 | Kinza Ali | Family Medicine | 2055 Kimball Avenue, Suite 101, Waterloo, IA 50702 | 2020-07-06 |
| 1073176533 | Sandeep Badyal | Family Medicine | Ne Ia Family Medicine Residency Program, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-19 |
| 1619530763 | Sophia Tariq Qureshi | Family Medicine | Ne Ia Medical Education Foundation, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-15 |
| 1659869915 | Alicia M Johnson | Advanced Practice Midwife | 439 King Street, Waterloo, IA 50702 | 2018-04-23 |
| 1427591411 | Alexandra E. Becker | Specialist/Technologist | 4157 Mourning Dove Drive, Waterloo, IA 50702 | 2016-11-23 |
| 1255793196 | Eastern Iowa Therapeutics PC | Physical Therapist | 1655 E San Marnan Dr, Ste A, Waterloo, IA 50702 | 2016-03-21 |
| 1972859288 | Noble Cedar Psychological Institute | Psychologist | 1425 W. 5th Street, Suite 1, Waterloo, IA 50702 | 2012-07-24 |
| 1417223363 | Rita Marie Menart | Counselor | 2101 Kimball Ave., Suite 138, Waterloo, IA 50702 | 2012-03-26 |
| 1336411685 | Jagpal Singh Suman | Hospitalist | 3421 West 9th Street, Waterloo, IA 50702 | 2012-02-02 |
| Find all providers in zip 50702 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346867439 | Kinza Ali | Family Medicine | 2055 Kimball Avenue, Suite 101, Waterloo, IA 50702 | 2020-07-06 |
| 1033777610 | Emily Rose Pursley | Family Medicine | Medical Arts Bldg., 2055 Kimball Ave. Suite 101, Waterloo, IA 50702-5070 | 2019-05-30 |
| 1609434281 | Shalini Chowdavarapu | Family Medicine | Ne Ia Family Practice Center, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702-5070 | 2019-05-30 |
| 1073176533 | Sandeep Badyal | Family Medicine | Ne Ia Family Medicine Residency Program, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-19 |
| 1619530763 | Sophia Tariq Qureshi | Family Medicine | Ne Ia Medical Education Foundation, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-15 |
| 1669826640 | Sapna Patel | Family Medicine | 2140 Logan Ave Ste C, Waterloo, IA 50703-1002 | 2016-04-15 |
| 1174752802 | Lane A Noble | Family Medicine | 2055 Kimball Ave Ste 100, Waterloo, IA 50702-5014 | 2009-07-01 |
| 1568698389 | Michelle Sarah Craig | Family Medicine | 2710 St. Francis Drive, Suite 210, Waterloo, IA 50702-5401 | 2009-06-08 |
| 1386879724 | Lydia Mustafic | Family Medicine | 2710 Saint Francis Dr Ste 210, Waterloo, IA 50702-5664 | 2009-05-28 |
| 1386651560 | David Robert Kobliska | Family Medicine | 2710 St.francis Dr, Waterloo, IA 50702-2081 | 2006-08-01 |
| Find all providers in WATERLOO | ||||
Please comment or provide details below to improve the information on SHANNA RUTH ELLIOTT.
| 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.