GREGORY D. SHANNON (NPI# 1700041456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700041456 |
| Entity Type | Individual |
| Full Name | GREGORY D. SHANNON |
| Credential | PSY.D |
| Practice Address |
1301 Kansas Hwy 264 Larned KS 67550-5353 |
| Practice Telephone | 6202854216 |
| Mailing Telephone | 6202854216 |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2008-07-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
T-LP 1742 | KS | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | KANSAS STATE LICENSE | T-LP 1742 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528694742 | Gregory Johnston Shannon | Counselor | 117 Wellington Rd, Shavertown, PA 18708-1341 | 2020-03-19 |
| 1730148495 | Gregory L. Shannon | Specialist | 17510 W Grand Pkwy S, #220, Sugar Land, TX 77479-2645 | 2006-03-21 |
| 1336240936 | Gregory David Shannon | Emergency Medicine | 1650 Haslett Rd, Haslett, MI 48840-8438 | 2006-09-26 |
| 1225049984 | Gregory D Shannon | Physician Assistant | 72780 Country Club Dr, Bldg B 203, Rancho Mirage, CA 92270-4126 | 2006-08-10 |
| Street Address |
1301 KANSAS HWY 264 |
| City | LARNED |
| State | KS |
| Zip Code | 67550-5353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427406784 | Amanda Haberman | Specialist/Technologist | 201 E 17th, Larned, KS 67550 | 2016-05-27 |
| 1619155512 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 908 E 14th St., Larned, KS 67550 | 2008-02-04 |
| 1801920699 | Bernadette Novotny | Physical Therapy Assistant | 1114 W 11 St, Learned, KS 67550 | 2007-03-15 |
| 1871699777 | Luis Alberto Perez | Chiropractor | 313 W 14th, Larned, KS 67550 | 2006-09-16 |
| 1245296821 | Smith Dental Clinic LLC | Dentist | 706 Ft Larnel Ave, Larnel, KS 67550 | 2006-04-24 |
| 1730140716 | Terry D Smith | Dentist | 706 Ft Larned Ave, Box 36, Larned, KS 67550 | 2006-03-30 |
| 1396378741 | April Corellia Bradshaw | Nurse Practitioner | 1301 Ks Highway 264, 1301 Ks Highway 264, Larned, KS 67550 | 2020-02-13 |
| 1770115115 | Corinne Janel Wray | Student in an Organized Health Care Education/Training Program | 512 W 1st St, Larned, KS 67550 | 2020-02-04 |
| 1053892059 | Andy Roger Eugene | Psychiatry & Neurology | 1301 Ks Highway 264, Larned, KS 67550 | 2018-08-27 |
| 1467413443 | Trent D Smith | Dentist | 706 Ft Larned Ave, Box 36, Larned, KS 67550 | 2006-03-30 |
| Find all providers in zip 67550 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780810879 | Mark Eugene Schutter | Psychologist | 300 Hillcrest Dr, Larned State Hospital, Larned, KS 67550-4000 | 2009-06-03 |
| 1487084695 | Angelina Maria Johnson | Psychologist | 1301 Ks Highway 264, Isaac Ray East 2, Larned, KS 67550-5353 | 2013-11-25 |
| 1225301666 | Angela Burcham | Psychologist | 1301 Ks Highway 264, Larned, KS 67550-5353 | 2012-02-15 |
| 1093086720 | Robin L. Karp | Psychologist | 1301 Ks Highway 264, Larned, KS 67550-5353 | 2012-01-26 |
| 1407187180 | Debra Lynn Vondracek | Psychologist | 1301 Ks Hwy 264, Larned, KS 67550-5353 | 2010-01-20 |
| 1487989141 | Kelly Christine Edison | Psychologist | 1301 Ks Hwy 264, Larned, KS 67550-5353 | 2009-10-13 |
| 1477707909 | Christina Eugenia Rudawski | Psychologist | 1301 Ks Hwy 264, Larned, KS 67550-5353 | 2008-11-11 |
| 1538311568 | Michael J. Klemens | Psychologist | 1301 Ks Highway 264, Larned, KS 67550-5353 | 2008-10-22 |
| 1154589372 | Rebecca Anne Farr | Psychologist | 1301 Ks Highway 264, Larned, KS 67550-5353 | 2008-05-23 |
| 1306032982 | Callista Frye | Psychologist | 1301 Ks Highway 264, Larned, KS 67550-5353 | 2007-09-18 |
| Find all providers in LARNED | ||||
Please comment or provide details below to improve the information on GREGORY D. SHANNON.
| 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.