SHANE B CARSON (NPI# 1710917299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710917299 |
| Entity Type | Individual |
| Full Name | SHANE B CARSON |
| Credential | D.O. |
| Practice Address |
1919 S Grand Blvd Spokane WA 99203-2347 |
| Mailing Address |
Po Box 421 Liberty Lake WA 99019-0421 |
| Practice Telephone | 5097473081 |
| Practice Fax Number | 5092277070 |
| Mailing Telephone | (509) 747-3081 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2017-05-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | OP00002101 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8454654 | 05 |
| Street Address |
1919 S GRAND BLVD |
| City | SPOKANE |
| State | WA |
| Zip Code | 99203-2347 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134192107 | Debra Ann Freund | Nurse Practitioner | 1919 S Grand Blvd, Spokane, WA 99203-2347 | 2006-02-09 |
| 1194355271 | Katherine Rossi Harris | Social Worker | 1919 S Grand Blvd, Spokane, WA 99203-2347 | 2020-01-17 |
| 1689961542 | Kaitlin Mallon | Nurse Practitioner | 1919 S Grand Blvd, Spokane, WA 99203 | 2011-06-29 |
| 1346488947 | Women First, Ps | Obstetrics & Gynecology | 1919 S Grand Blvd, Suite A, Spokane, WA 99203-2347 | 2009-02-04 |
| 1306877196 | Betty Ann Hartley-keith | Nurse Practitioner | 1919 S Grand Blvd, Spokane, WA 99203-2347 | 2006-07-06 |
| 1699705160 | Cindy K Hollenbaugh | Pediatrics | 1919 S Grand Blvd, Spokane, WA 99203-2347 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164992541 | Ashley Thunder Hawk | Massage Therapist | 1001 W 25th Ave # 2, Spokane, WA 99203 | 2018-11-28 |
| 1134612500 | Jill Johnston | Nurse Practitioner | 1418 S Tacoma St, Spokane, WA 99203 | 2018-06-11 |
| 1356731988 | Rebekah Elizabeth Alice | Midwife | 417 E 28th Ave, Spokane, WA 99203 | 2015-02-03 |
| 1295155455 | Jordan Diamond | Dentist | 2204 E 29th Ave Ste 104, Spokane, WA 99203 | 2014-04-25 |
| 1952687386 | Providence Phsyician Services | Family Medicine | 1919 S. Grand Blvd., Spokane, WA 99203 | 2011-10-31 |
| 1033411103 | Patricia Mary Bedalov | Speech-Language Pathologist | 1017 W. 26th Ave., Spokane, WA 99203 | 2010-11-23 |
| 1841591310 | Travis Craig Romney | Chiropractor | 1403 S Grand Blvd., Suite 101s, Spokane, WA 99203 | 2010-11-15 |
| 1942518154 | South Hill Pediatric Dentistry | Dentist | 2020 E 29th Avenue, 130, Spokane, WA 99203 | 2010-09-22 |
| 1942512421 | Judy Lynn Budrow | Massage Therapist | 1805 E. 36th, Spokane, WA 99203 | 2010-07-13 |
| 1871741843 | Elisabeth Carroll Bagby | Massage Therapist | 132 W. 32nd Ave., Spokane, WA 99203 | 2008-09-03 |
| Find all providers in zip 99203 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043706583 | Healthy Schools Washington, Pllc | Pediatrics | 1028 West Rosewood Ave, Spokane, WA 99208 | 2018-07-09 |
| 1740690049 | Ashley Claire Mccorkhill | Pediatrics | 1514 S Tacoma St, Spokane, WA 99203-2260 | 2014-05-07 |
| 1891001277 | Providence Physician Services Co | Pediatrics | 5901 N Linderwood, Suite 126, Spokane, WA 99207 | 2010-08-24 |
| 1568591923 | Bridget Z Duffy | Pediatrics | 1111 E Westview Ct Ste B, Spokane, WA 99218-1376 | 2007-03-03 |
| 1831296177 | Deborah Ann Icenogle | Pediatrics | 5011 W Lowell Ave Ste 100, Spokane, WA 99208-8587 | 2006-09-20 |
| 1417061169 | Joseph B Mcmanus | Pediatrics | 5901 N Lidgerwood, Suite 220, Spokane, WA 99208 | 2006-08-19 |
| 1962494393 | David R Fregeau | Pediatrics | 101 W Eighth, Spokane, WA 99220-2555 | 2005-08-22 |
| 1932680949 | Spokane Pediatrics Pllc | Pediatrics | 315 W 9th Ave Ste 200, Spokane, WA 99204 | 2018-08-27 |
| 1396253910 | Grand Pediatrics, P.s. | Pediatrics | 1402 S Grand Blvd, Spokane, WA 99203-5001 | 2018-01-17 |
| 1275053514 | Angela Denise Beauchamp | Pediatrics | 1402 S Grand Blvd, Spokane, WA 99203-5001 | 2017-06-27 |
| Find all providers in SPOKANE | ||||
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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.