SHANLEY BROOKE SHELBURNE (NPI# 1679927123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679927123 |
| Entity Type | Individual |
| Full Name | SHANLEY BROOKE SHELBURNE |
| Other Name | SHANLEY BROOKE CHURCH |
| Credential | PA-C |
| Practice Address |
1800 Combs Rd Suite 7 Pennington Gap VA 24277-1808 |
| Mailing Address |
41830 E Morgan Ave Ste 202 Pennington Gap VA 24277-3218 |
| Practice Telephone | 2765464894 |
| Mailing Telephone | 3365123162 |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2017-05-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
TC481 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0110-005327 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1800 COMBS RD SUITE 7 |
| City | PENNINGTON GAP |
| State | VA |
| Zip Code | 24277-1808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417920984 | John Scott Litton Jr. | Family Medicine | 1800 Combs Rd, Suite 7, Pennington Gap, VA 24277-1808 | 2006-02-07 |
| 1295964179 | Mary Gehring Hayes | Nurse Practitioner | 1800 Combs Rd, Pennington Gap, VA 24277-1808 | 2009-07-13 |
| 1265624613 | Patrick A. Molony, Md Pa | Clinic/Center | 1800 Combs Rd, Suite 11, Pennington Gap, VA 24277-1808 | 2007-08-09 |
| 1285731463 | Litton Family Medicine PC | Family Medicine | 1800 Combs Rd, Suite 7, Pennington Gap, VA 24277-1808 | 2006-09-20 |
| 1861595530 | Medical Imaging P.C. | Radiology | 1800 Combs Rd, Pennington Gap, VA 24277-1808 | 2006-09-07 |
| 1528080207 | Ronald Peter Hill | Emergency Medicine | 1800 Combs Rd, Pennington Gap, VA 24277-1808 | 2006-07-24 |
| 1841221397 | B Allen Kolodziej | Emergency Medicine | 1800 Combs Rd, Pennington Gap, VA 24277-1808 | 2006-07-05 |
| 1750310561 | Phanel Basile | Emergency Medicine | 1800 Combs Rd, Pennington Gap, VA 24277-1808 | 2006-07-02 |
| 1386673119 | Stanislav T Merka | Emergency Medicine | 1800 Combs Rd, Pennington Gap, VA 24277-1808 | 2006-07-02 |
| 1518905504 | Suhasini Moparty | Pediatrics | 1800 Combs Rd, Suite 4, Pennington Gap, VA 24277-1808 | 2006-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639653686 | Tanya L Clark | Physical Therapist | 208 Health Care Drive, Pennington Gap, VA 24277 | 2018-09-15 |
| 1780066407 | Daniel Maurer | Psychologist | Lee County Industrial Park, Hickory Flats Road, Pennington Gap, VA 24277 | 2015-06-19 |
| 1952428864 | Valerie Renee Taylor | Physical Therapy Assistant | 1565 W. Morgan Ave, Pennington Gap, VA 24277 | 2007-03-23 |
| 1043358807 | Carolyn Sue Cope | Counselor | 430 Industrial Drive, Pennington Gap, VA 24277 | 2007-02-02 |
| 1417069725 | Angela Renee Mullins-russell | Counselor | 711 W Morgan Ave, Pennington Gap, VA 24277 | 2006-08-31 |
| 1548376403 | James Monroe Roberson Jr. | Dentist | 127 South Kentucky Street, Pennington Gap, VA 24277 | 2006-08-22 |
| 1053424721 | John C. Marion-pharmacist,p.c. | Pharmacist | 1724 Combs Road, Pennington Gap, VA 24277 | 2006-08-16 |
| 1134132319 | Hossein Faiz | Surgery | Lee Regional Medical Center 1800 Combs Rd, Medical Arts Plaza Suite 2, Pennington Gap, VA 24277 | 2006-08-15 |
| 1174564389 | Pennington Gap Hma Inc | Medicare Defined Swing Bed Unit | West Morgan Avenue, Pennington Gap, VA 24277 | 2006-06-09 |
| 1033159728 | Pennington Gap Hma Inc | General Acute Care Hospital | West Morgan Ave, Pennington Gap, VA 24277 | 2006-06-08 |
| Find all providers in zip 24277 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124638986 | Courtney Anne Kassner | Physician Assistant | 2706 Davis Ave, Alexandria, VA 22302-2817 | 2020-08-06 |
| 1295356145 | Nilofar Ariasaif | Physician Assistant | 15401 Bald Eagle Ln, Woodbridge, VA 22191-3782 | 2020-05-01 |
| 1396366555 | Sheelon Aghili | Physician Assistant | 5801 Hampton Forest Way, Fairfax, VA 22030-7254 | 2020-04-29 |
| 1679102347 | Mary Herrera | Physician Assistant | 6353 Center Dr Ste 204, Norfolk, VA 23502-0001 | 2020-04-05 |
| 1720614019 | Andrew James Meyers | Physician Assistant | 229 W Bute St Apt 207, Norfolk, VA 23510-1415 | 2020-03-18 |
| 1902432644 | Madison Alexis Cooper | Physician Assistant | 920 Battlefield Blvd S Ste 101, Chesapeake, VA 23322-4254 | 2020-03-13 |
| 1285296111 | Kimberly Stewart Hugo | Physician Assistant | 10932 Point Grey Road, Henrico, VA 23233-2429 | 2019-07-01 |
| 1558824698 | Jessica Leigh Pacuch | Physician Assistant | 2440 Raphine Rd, Raphine, VA 24472-2541 | 2019-04-06 |
| 1073074431 | Nicholas Alexander Jones | Physician Assistant | 924 Parley Pl, Chesapeake, VA 23323-4135 | 2019-03-28 |
| 1003371410 | Ryan Timothy Pyles | Physician Assistant | 25 Commerce Park Drive, Raphine, VA 24472 | 2019-02-11 |
| Find all providers with the same taxonomy | ||||
| City | PENNINGTON GAP |
| Zip Code | 24277 |
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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.