SHANNON TUCKER (NPI# 1730575218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730575218 |
| Entity Type | Individual |
| Full Name | SHANNON TUCKER |
| Credential | PA |
| Practice Address |
1215 Lee St Charlottesville VA 22908-4500 |
| Mailing Address |
Po Box 9007 Charlottesville VA 22906-9007 |
| Practice Telephone | 4342433090 |
| Practice Fax Number | 4342449445 |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2017-09-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0110005762 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA00245 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 05059577 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972165926 | Shannon D Tucker | Case Manager/Care Coordinator | 1921 Ransom Pl, Nashville, TN 37217-3841 | 2019-06-30 |
| 1184102642 | Shannon E Tucker | Licensed Vocational Nurse | 9846 Hwy 31 E, Tyler, TX 75705-2329 | 2018-08-06 |
| 1386048023 | Shannon L Tucker | Registered Nurse | 3009 N Ballas Rd, Ste 264c, Saint Louis, MO 63131-2322 | 2014-10-09 |
| 1194140517 | Shannon L Tucker | Psychologist | 1 Rapp Rd, Albany, NY 12203 | 2014-02-21 |
| 1174874838 | Shannon Schou Tucker | Counselor | 1776 S Jackson St, Suite 700, Denver, CO 80210-3801 | 2012-09-21 |
| 1073817565 | Shannon Renee Tucker | Counselor | 7777 E Us Highway 66, El Reno, OK 73036-9125 | 2010-12-27 |
| 1346322112 | Shannon Lynn Tucker | Speech-Language Pathologist | 210 E Woodlawn Rd, Suite 150, Charlotte, NC 28217-2202 | 2006-10-20 |
| Street Address |
1215 LEE ST |
| City | CHARLOTTESVILLE |
| State | VA |
| Zip Code | 22908-4500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760486328 | Kirk W Tanner | Nurse Anesthetist, Certified Registered | 1215 Lee St, Charlottesville, VA 22908-0816 | 2005-06-10 |
| 1801493283 | Angela Jewell Strickler | Nurse Practitioner | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-10-08 |
| 1629675475 | Kimberlee M Mauck | Physician Assistant | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-10-05 |
| 1407463953 | Amy Johnston | Clinical Nurse Specialist | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-09-29 |
| 1194332882 | Mihwa Ahn | Nurse Practitioner | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-09-26 |
| 1346856721 | Farren Hume Dodson | Nurse Practitioner | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-09-21 |
| 1003422619 | Darlene Acero | Dietitian, Registered | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-09-18 |
| 1689289571 | Erin Harr | Nurse Practitioner | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-09-09 |
| 1518572460 | Juan Pablo Sardi Restrepo | Student in an Organized Health Care Education/Training Program | 1215 Lee St, Mail Stop 800212, Charlottesville, VA 22908-0816 | 2020-09-08 |
| 1366055956 | Erin Louise Tennyson | Nurse Practitioner | 1215 Lee St, Charlottesville, VA 22908-0816 | 2020-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568020410 | Alexis Evans | Physician Assistant | 1215 Lee St Nnicu, Charlottesville, VA 22908 | 2019-06-04 |
| 1649702317 | Ryan Aschenbrener | Student in an Organized Health Care Education/Training Program | 545 Ray C Hunt Drive Suite 2400, Charlottesville, VA 22908 | 2017-03-31 |
| 1215399241 | Katherine Gresham Belote | Student in an Organized Health Care Education/Training Program | 1221 Lee Street Uva Health System, Charlottesville, VA 22908 | 2016-03-29 |
| 1851776215 | Catherine Meller | Student in an Organized Health Care Education/Training Program | 1215 Lee St., Box 800713, Charlottesville, VA 22908 | 2015-07-28 |
| 1295112597 | Breanna Campbell | Internal Medicine | 1220 Lee St Ste 2401, Charlottesville, VA 22908 | 2015-05-06 |
| 1013255637 | Melinda Bowles-childress | Nurse Practitioner | 1 Hospital Dr Fl 1, Charlottesville, VA 22908 | 2013-01-17 |
| 1053521757 | Univeristy of Virginia Health System | General Acute Care Hospital | University of Virginia Health System, 1215 Lee Street, Chalrlottesville, VA 22908 | 2007-05-23 |
| 1730241282 | Imre Noth | Internal Medicine | 1221 Lee St Fl 2, Charlottesville, VA 22908 | 2006-12-14 |
| 1023185394 | Tamer Ghanem | Otolaryngology | Dept. Otolaryngology, University of Virginia, 1 Hospital Dr., 2nd Floor Oms Rm 2747, Charlottesville, VA 22908 | 2006-11-29 |
| 1366401242 | Lisa M Christianson | Obstetrics & Gynecology | Uva Elson Student Health Center, 400 Brandon Avenue, Charlottesville, VA 22908 | 2006-03-21 |
| Find all providers in zip 22908 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568020410 | Alexis Evans | Physician Assistant | 1215 Lee St Nnicu, Charlottesville, VA 22908 | 2019-06-04 |
| 1912562406 | Danielle Shell | Physician Assistant | 1254 Clover Ridge Pl, Charlottesville, VA 22901-9213 | 2019-05-09 |
| 1265953699 | Gina J Carroll | Physician Assistant | 2625 Cedar Ridge Ln, Charlottesville, VA 22901-9414 | 2017-07-06 |
| 1134585961 | Natalie Smith | Physician Assistant | 183 Spotnap Rd Ste C, Charlottesville, VA 22911-8812 | 2016-01-08 |
| 1093185167 | Emily Harriet Gilbert | Physician Assistant | 100 1st St N Apt 202, Charlottesville, VA 22902-5251 | 2015-10-01 |
| 1679815930 | Lindsay R Caine-conley | Physician Assistant | 103 S Pantops Dr Ste 102, Charlottesville, VA 22911-8617 | 2013-03-25 |
| 1376829184 | Traci L. Mahoney | Physician Assistant | 545 Ray C Hunt Dr Ste 140, Charlottesville, VA 22903 | 2011-10-25 |
| 1699951152 | Michelle Louise Post | Physician Assistant | 545 Ray C. Hunt Drive, Ste 310, Charlottesville, VA 22903-7851 | 2008-01-15 |
| 1932223674 | Alden R. Kent | Physician Assistant | 1st Lee St, Charlottesville, VA 22908-0001 | 2007-03-19 |
| 1124142229 | Jennifer A. Hart | Physician Assistant | 1000 Massie Rd, Charlottesville, VA 22903 | 2007-03-16 |
| Find all providers in CHARLOTTESVILLE | ||||
| City | CHARLOTTESVILLE |
| Zip Code | 22908 |
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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.