DR. SHANNON MARIE KELLY (NPI# 1699268821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699268821 |
| Entity Type | Individual |
| Full Name | DR. SHANNON MARIE KELLY |
| Credential | DMD |
| Practice Address |
200 N Royal Tower Dr Irmo SC 29063 |
| Mailing Address |
200 N Royal Tower Dr Irmo SC 29063-2747 |
| Practice Telephone | 8037323090 |
| Mailing Telephone | 8037323090 |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2018-07-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
9158 | SC | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
DN23453 | FL | Dental 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 |
| 1578991790 | Shannon Kelly | Pharmacist | 2792 Lea Lake Rd, Blaine, TN 37709-5214 | 2013-10-25 |
| 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 |
200 N ROYAL TOWER DR |
| City | IRMO |
| State | SC |
| Zip Code | 29063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720603640 | Daniel Witcher | Counselor | 1180 Columbia Avenue, Suite 203, Irmo, SC 29063 | 2020-06-16 |
| 1710512140 | Arie Anew Services Incorporated | Psychologist | 7803 St. Andrews Road, C5, Irmo, SC 29063 | 2020-03-05 |
| 1366922296 | Jennie C Beym | Speech-Language Pathologist | 7 Tip Top Court, Irmo, SC 29063 | 2018-08-20 |
| 1295214088 | The Well LLC | Massage Therapist | 1720 Dutch Fork Rd., Irmo, SC 29063 | 2018-08-13 |
| 1497243174 | Anthony Batiste Thompson Jr. | Behavior Technician | 137 Chapelwhite Road, Irmo, SC 29063 | 2018-04-27 |
| 1578076022 | Demario Sawyer Sr | Ambulance | 107 N Royal Tower Dr Ste C, Irmo, SC 29063 | 2017-11-07 |
| 1306365713 | Dreher Shuler | Student in an Organized Health Care Education/Training Program | 205 River Creek Drive, Irmo, SC 29063 | 2017-09-18 |
| 1053833442 | Tania Rodriguez | Social Worker | 30 Ash Court, Irmo, SC 29063 | 2017-07-07 |
| 1598294944 | Ashley Elaine Bradley | Home Health | 120 Stockland Rd, Irmo, SC 29063 | 2017-06-08 |
| 1912440785 | Suzanne Michelle Makarski | Social Worker | 7803 Saint Andrews Road, Suite C2, Irmo, SC 29063 | 2016-11-28 |
| Find all providers in zip 29063 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730619495 | Joshua Fulton | Dentist | 7897 Broad River Rd, Irmo, SC 29063-2357 | 2017-06-15 |
| 1215399977 | Kelcy Ann Huddle | Dentist | 7241 Broad River Rd Ste 90, Irmo, SC 29063-8164 | 2016-03-22 |
| 1225419930 | Patrick William Orman Iv | Dentist | 7210 Broad River Rd Ste N, Irmo, SC 29063-8150 | 2015-06-18 |
| 1144534223 | Allen Crosby Livingston Jr. | Dentist | 1028 Kinley Road, Irmo, SC 29063-9632 | 2010-08-02 |
| 1417100371 | Childrens Dental Group of South Carolina | Dentist | 7210k Broad River Rd, Irmo, SC 29063-7973 | 2008-10-23 |
| 1619139482 | Sherry Benenhaley Rauch | Dentist | 7436 Broad River Rd, Suite 111, Irmo, SC 29063-7601 | 2008-07-01 |
| 1760664304 | Distinctive Dentistry | Dentist | 11107 Broad River Rd, Suite D, Irmo, SC 29063-7602 | 2007-12-05 |
| 1255463808 | A. Crosby Livingston, Jr., Dmd, Pa | Dentist | 1028 Kinley Rd, Irmo, SC 29063-9632 | 2007-03-09 |
| 1992849624 | Gregory Joseph Wych | Dentist | 7505 Saint Andrews Rd, Irmo, SC 29063 | 2007-02-16 |
| 1043350507 | Michelle Lynne Mistele | Dentist | 3533 Dreher Shoals Rd, Irmo, SC 29063-9115 | 2007-02-07 |
| Find all providers in IRMO | ||||
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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.