MR. SHANE DAVID ANDERSON (NPI# 1720523418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720523418 |
| Entity Type | Individual |
| Full Name | MR. SHANE DAVID ANDERSON |
| Credential | FNP-C |
| Practice Address |
6316 Old Oak Ridge Rd Greensboro NC 27410-9939 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3366051337 |
| Practice Fax Number | 3366053776 |
| Mailing Telephone | 3366051337 |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2020-10-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 5009250 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
5009250 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295168433 | Shane Robert Anderson | Otolaryngology | 1106 Beechwood St, Hillcrest, Little Rock, AR 72205 | 2013-08-12 |
| 1750513040 | Shane Michael Anderson | Counselor | 1643 Sr 104, Chillicothe, OH 45601 | 2009-08-20 |
| 1841289659 | Shane Keith Anderson | Internal Medicine | 220 Bannock St, Malad City, ID 83252-1256 | 2005-10-14 |
| 1952863946 | Shane Corbin Anderson | Student in an Organized Health Care Education/Training Program | 462 Grider St, Buffalo, NY 14215-3021 | 2019-04-01 |
| 1497002299 | Shane S Anderson | Pharmacist | 1502 N Vercler Rd, Spokane Valley, WA 99216 | 2012-08-10 |
| 1639461635 | Shane M Anderson | Pharmacist | 402 S 4th Ave, Yakima, WA 98902-3546 | 2011-05-09 |
| 1144208661 | Shane Blake Anderson | Nuclear Medicine | 3551 Roger Brooke Dr, Brooke Army Medical Center, Fort Sam Houston, TX 78234-4504 | 2006-01-04 |
| 1952383432 | Shane Selassie Anderson | Pathology | 1001 Sw Klickitat Way, 205, Seattle, WA 98134-1161 | 2005-11-18 |
| Street Address |
6316 OLD OAK RIDGE RD |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27410-9939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518398098 | Novant Medical Group, Inc | Family Medicine | 6316 Old Oak Ridge Rd, Suite E, Greensboro, NC 27410-9940 | 2013-12-09 |
| 1497209613 | Digestive Health Specialists, Pa | Internal Medicine | 6316 Old Oak Ridge Rd, Greensboro, NC 27410-9939 | 2016-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669095014 | Well-spring Home Care LLC | In Home Supportive Care | 3859 Battleground Avenue, Suite 301, Greensboro, NC 27410 | 2020-05-20 |
| 1679139372 | Iora Health North Carolina, P.C. | Internal Medicine | 3351 Battleground Ave., Greensboro, NC 27410 | 2019-05-17 |
| 1669950689 | Matthew W Devaney Dds @ Brassfield, Pa | Dentist | 2018 New Garden Rd D., Greensboro, NC 27410 | 2018-08-01 |
| 1306323951 | Carolina Children's Eye Care, Pa | Ophthalmology | Friendly-holden Building, 3608 W Friendly Ave, Suite 101, Greensboro, NC 27410 | 2018-07-26 |
| 1457846495 | Courtney Canty James | Pharmacist | 3300 W Friendly Ave, Greensboro, NC 27410 | 2018-06-22 |
| 1063904506 | Jonathan Hunt | Dentist | 5506 W Friendly Ave Ste 101, Greensboro, NC 27410 | 2018-05-31 |
| 1487158549 | Ruth Ann Foster | Registered Nurse | 3005 Steepleton Colony Court, Greensboro, NC 27410 | 2018-03-22 |
| 1568973360 | Novant Medical Group Inc. | Internal Medicine | 1622 Highwoods Blvd Unit G105, Greensboro, NC 27410 | 2017-10-19 |
| 1942724729 | Greenbrook Tms Greensboro LLC | Psychiatry & Neurology | 1931 New Garden Rd Ste 108, Greensboro, NC 27410 | 2017-08-02 |
| 1750810156 | Ibrahim Koroma | Home Health Aide | 4907 Hickory Woods Dr, Greensboro, NC 27410 | 2017-06-08 |
| Find all providers in zip 27410 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235789793 | Sarah Clegg Slack | Nurse Practitioner | 912 3rd St # 101, Greensboro, NC 27405-6967 | 2019-09-17 |
| 1881243558 | Kathryn Strup | Nurse Practitioner | 1317 N Elm St Ste 7, Greensboro, NC 27401-1023 | 2019-09-05 |
| 1174989792 | Elysa C. Graham | Nurse Practitioner | 1919 Boulevard St Ste A, Greensboro, NC 27407-4595 | 2016-01-12 |
| 1588033195 | Maria S. Gaddy | Nurse Practitioner | 1000 Cowles Clinc Way Ste M-200, Greensboro, GA 30642-4541 | 2015-09-24 |
| 1689042038 | Caroline Tedder Hacker | Nurse Practitioner | 300 E Wendover Ave, Suite 400, Greensboro, NC 27401-1229 | 2015-09-02 |
| 1659700177 | Jerry Keith Edwards | Nurse Practitioner | 501 Hickory Branch Rd, Greensboro, NC 27409-9601 | 2013-11-05 |
| 1609185255 | Yolanda Mcclam Nicholson | Nurse Practitioner | 112 N Benbow Road, Greensboro, NC 27411-7299 | 2010-09-30 |
| 1740594357 | Karen M Black | Nurse Practitioner | 1200 N Elm St Ste 3509, Greensboro, NC 27401-1004 | 2010-08-06 |
| 1235397738 | Russell Lee Welch | Nurse Practitioner | 510 N.elam Ave, Ste 302, Greensboro, NC 27403 | 2008-05-30 |
| 1174614259 | Vrinda Villa Pickering | Nurse Practitioner | 1200 North Elm Street, Greensboro, NC 27401-1004 | 2006-09-27 |
| Find all providers in GREENSBORO | ||||
| City | GREENSBORO |
| Zip Code | 27410 |
Please comment or provide details below to improve the information on MR. SHANE DAVID ANDERSON.
| 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.