SHAWN MARIE DESMOND (NPI# 1740342112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740342112 |
| Entity Type | Individual |
| Full Name | SHAWN MARIE DESMOND |
| Credential | RN, MSN, CPNP |
| Practice Address |
3505 Converse Dr Suite 200 Wilmington NC 28403-6131 |
| Practice Telephone | 9103925634 |
| Practice Fax Number | 9103925654 |
| Mailing Telephone | 9103925634 |
| Mailing Fax Number | 9103925654 |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2015-05-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
300318 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | DEA NUMBER | DEA MZ1201122 | 01 |
| NC | STATE MEDICAL BOARD LICEN | 300318 | 01 |
| NC | LICENSE FOR RN | 114434 | 01 |
| Street Address |
3505 CONVERSE DR SUITE 200 |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28403-6131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073532248 | Dimock Weinberg & Cherry Dds Pllc | Dentist | 3505 Converse Dr, Suite 175, Wilmington, NC 28403-6131 | 2006-07-19 |
| 1225524473 | Michelle Espinoza | Behavioral Analyst | 3505 Converse Dr, Wilmington, NC 28403-6131 | 2018-07-10 |
| 1821519125 | Ashley Jill Koehler | Occupational Therapist | 3505 Converse Dr, Wilmington, NC 28403-6131 | 2017-06-28 |
| 1760865760 | Kidzcare Pediatrics, PC | Pediatrics | 3505 Converse Dr, Suite 200, Wilmington, NC 28403-6131 | 2015-07-08 |
| 1447638341 | Coastal Pediatric Associates, Pllc | Specialist | 3505 Converse Dr, Suite 200, Wilmington, NC 28403-6131 | 2015-05-12 |
| 1891194015 | Raleigh Durham Medical Group, Pa | Pediatrics | 3505 Converse Dr, Ste 200, Wilmington, NC 28403-6131 | 2014-08-14 |
| 1821327768 | Shannon Dee Keely | Registered Nurse | 3505 Converse Dr, Suite 200, Wilmington, NC 28403-6131 | 2009-12-23 |
| 1861628695 | Breony Miller Vinson | Physician Assistant | 3505 Converse Dr, Suite 200, Wilmington, NC 28403-6131 | 2009-06-08 |
| 1588898571 | Whitney Nugent King | Pediatrics | 3505 Converse Dr, Suite 200, Wilmington, NC 28403-6131 | 2009-05-06 |
| 1912094301 | Thomas L Blackstone | Pediatrics | 3505 Converse Dr, Ste 200, Wilmington, NC 28403-6132 | 2006-10-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413875 | Ymca of Southeastern Nc | Health Educator | 2710 Market Street, Wilmington, NC 28403 | 2020-09-25 |
| 1659917334 | Noa Alper | Occupational Therapist | 5412 Old Garden Road, Wilmington, NC 28403 | 2019-11-18 |
| 1992346340 | Nancy Rosita Carson | Technician | 5608 Locke Str. Apt 108, Wilmington, NC 28403 | 2019-10-07 |
| 1912484585 | Jennifer Nicole Perry | Behavior Technician | 349 Campus Cv, Wilmington, NC 28403 | 2018-07-25 |
| 1386159929 | Monumental Foundations LLC | Clinic/Center | Plum Tree Plaza 925 South Kerr Ave Suite F4, Wilmington, NC 28403 | 2017-12-05 |
| 1114445731 | Jacqulyn Craichy | Speech-Language Pathologist | 75 Cavalier Drive, Wilmington, NC 28403 | 2017-09-04 |
| 1730638545 | Ashley Mcneil | Durable Medical Equipment & Medical Supplies | 3435 Wilshire Blvd Apt 203, Wilmington, NC 28403 | 2016-09-22 |
| 1306204276 | Valerie Pringle Jones | Physical Therapist | 1717 Shipyard Blvd. Ste 350, Wilmington, NC 28403 | 2016-02-05 |
| 1689039992 | Lifeline Treatment Center | Clinic/Center | 5710 Oleander Dr Ste 100, Wilmington, NC 28403 | 2015-12-31 |
| 1750758264 | Melissa Beatson | Speech-Language Pathologist | 4014 Oleander Drive, Ste. 3b, Coastal Speech & Language Pllc, Wilmington, NC 28403 | 2015-09-01 |
| Find all providers in zip 28403 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538641147 | Taylor Rippy | Nurse Practitioner | 2304 Delaney Ave, Wilmington, NC 28403-6013 | 2018-08-30 |
| 1891234563 | Christina Marie Fischer | Nurse Practitioner | 3521 Silverside Rd Ste 1b, Wilmington, DE 19810-4900 | 2017-02-14 |
| 1942413448 | Diane Jeane Disabatino | Nurse Practitioner | 963 Centre Rd, New Castle County Detention Medical, Wilmington, DE 19805-1268 | 2007-05-08 |
| 1588728232 | Glenda K Mclean | Nurse Practitioner | 2501 Ebright Rd, Wilmington, DE 19810-1125 | 2006-12-20 |
| 1801987144 | Patricia Mccall Jones | Nurse Practitioner | 3521 Silverside Rd Ste 1f, Brandywine Pediatrics, Wilmington, DE 19810-4917 | 2006-09-28 |
| 1073114831 | Tiffany Allen | Nurse Practitioner | 1184 W Locust St, Wilmington, OH 45177-2009 | 2020-11-06 |
| 1902346554 | Roseann Marie Hausmann | Nurse Practitioner | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2017-03-01 |
| 1134505738 | Julie Andrews | Nurse Practitioner | 2131 S 17th St, Wilmington, NC 28401-7407 | 2015-08-05 |
| 1316344211 | Emily Sara Friedlander | Nurse Practitioner | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2014-11-21 |
| 1699174417 | Amber Williams Banta | Nurse Practitioner | 4005 Oleander Dr, Wilmington, NC 28403-6816 | 2014-08-18 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28403 |
Please comment or provide details below to improve the information on SHAWN MARIE DESMOND.
| 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.