SHANNON KATHLEEN LEIKERT (NPI# 1720511942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720511942 |
| Entity Type | Individual |
| Full Name | SHANNON KATHLEEN LEIKERT |
| Credential | D.O. |
| Practice Address |
3901 Beaubien St Detroit MI 48201-2119 |
| Mailing Address |
4201 St. Antoine Uhc 5d - Mailbox 226 Detroit MI 48201-2153 |
| Practice Telephone | 3137451892 |
| Mailing Telephone | 3139665051 |
| Mailing Fax Number | 3139660665 |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2020-09-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 5101023233 | MI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
3901 BEAUBIEN ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538151238 | Mark Campbell | Nurse Anesthetist, Certified Registered | 3901 Beaubien St, Detroit, MI 48201-2119 | 2005-08-18 |
| 1164037735 | Mamdouh Dakhel A Alahmadi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-09-10 |
| 1801407119 | Samantha Mulkiten | Nurse Practitioner | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-08-11 |
| 1346864550 | Mariane Tomiyoshi Asato | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-06-03 |
| 1629691613 | Abigail Marie Troy | Pediatrics | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-05-25 |
| 1235750373 | Katherine Marie Obudzinski | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-04-29 |
| 1548880073 | Sara Mercedes Evans | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-24 |
| 1619597069 | Zahur Fatima Sallman | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-24 |
| 1154941706 | Saira Tariq | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-23 |
| 1063032688 | Michael Allen Finkel | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| 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 |
|---|---|---|---|---|
| 1730708058 | Xuexin Lu | Pediatrics | 22101 Moross Rd Ste 80, Detroit, MI 48236-2148 | 2020-04-16 |
| 1235636408 | Healthy Kids Plc | Pediatrics | 18060 Conant St, Detroit, MI 48234-1628 | 2018-04-12 |
| 1841720539 | Krystal Yee-yun Chan-zlatopolsky | Pediatrics | 22201 Moross Rd Ste 80, Detroit, MI 48236-2166 | 2017-06-14 |
| 1508220062 | Marlisa Rose Wolf | Pediatrics | Children's Hospital of Mi - 3rd Fl, 3901 Beaubien, Detroit, MI 48201 | 2016-04-11 |
| 1821418419 | Christina Louise Santia | Pediatrics | Children's Hospital of Mi/ Spec Ctr, 3950 Beaubien Garden Level, Detroit, MI 48201 | 2014-04-22 |
| 1033537089 | Kimberly Lynn Herrmann | Pediatrics | Children's Hospital of Mi / Spec Ctr, 3950 Beaubien, Detroit, MI 48201 | 2014-04-06 |
| 1932540622 | Ramya Deepthi Billa | Pediatrics | 3901 Beaubien - 3rd Fl, Children's Hospital of Mi, Detroit, MI 48201 | 2013-07-10 |
| 1942646658 | Silpa Nadella | Pediatrics | 3950 Beaubien St Fl 4, Detroit, MI 48201-2166 | 2013-05-21 |
| 1770826984 | Lonetta L Postell | Pediatrics | 3031 W. Grand Blvd, 800, Detroit, MI 48202-2119 | 2013-04-05 |
| 1578806964 | Scott C Grant | Pediatrics | Chm/specialty Center, 3950 Beaubien 1st Fl, Detroit, MI 48201 | 2013-04-03 |
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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.