HEATHER MARIAN SHANNON (NPI# 1790775005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790775005 |
| Entity Type | Individual |
| Full Name | HEATHER MARIAN SHANNON |
| Credential | NP |
| Practice Address |
522 S 4th St Ste 500 Fulton NY 13069 |
| Mailing Address |
239 Oneida Street Attn: Paula Baker Fulton NY 13069 |
| Practice Telephone | 3155984740 |
| Practice Fax Number | 3155984728 |
| Mailing Telephone | 3155984715 |
| Mailing Fax Number | 3155984751 |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2019-03-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
00420826 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367A00000X | Advanced Practice Midwife | F000678-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02381762 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 725 Irving Ave, Suite 600, Syracuse, NY 132101603 | 3154645162 | 3154644613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295384055 | Heather Elyse Shannon | Physical Therapist | 11330 Maple Brook Dr, Louisville, KY 40241-2080 | 2019-09-05 |
| 1720596315 | Heather Parkey Shannon | Specialist/Technologist | 6301 Gaston Ave Ste 750, Dallas, TX 75214-3922 | 2018-01-17 |
| 1164721239 | Heather Shannon | Counselor | 1200 N Ashland Ave, 3rd Floor, Chicago, IL 60622-2259 | 2011-03-15 |
| 1669678546 | Heather Harmon Shannon | Nurse Practitioner | 80 Health Park Dr Ste 100, Louisville, CO 80027-4644 | 2007-06-26 |
| Street Address |
522 S 4TH ST STE 500 |
| City | FULTON |
| State | NY |
| Zip Code | 13069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861701799 | Samantha Sheggrud | Physician Assistant | 522 S 4th St Ste 500, Fulton, NY 13069-2936 | 2010-09-27 |
| 1255449948 | Lisa J. Sousou | Physician Assistant | 522 S 4th St Ste 500, Fulton, NY 13069-2936 | 2006-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588291454 | Awilda Vega Johnston | Counselor | 92 N. 2nd St., #100, Fulton, NY 13069 | 2020-03-23 |
| 1174169346 | Gabrielle Sunshine Chrestler | Technician | 2118 Co Rt 176, Fulton, NY 13069 | 2019-11-22 |
| 1558917310 | Renee Omsby | Technician | 1323 County Rte 9, Fullton, NY 13069 | 2019-08-16 |
| 1194208488 | Bridgette Lynn Godfrey | Registered Nurse | 167 South 4th Street, Fulton, NY 13069 | 2018-09-12 |
| 1205299195 | Nu-ops, Inc | Taxi | 107 West 4th St So, Fulton, NY 13069 | 2016-03-30 |
| 1770909061 | Siobhan Anne Walsh | Licensed Practical Nurse | 436 Rowlee Road, Fulton, NY 13069 | 2014-03-11 |
| 1982971743 | Jennifer Lynn Scaringi | Licensed Practical Nurse | 505 Seneca St, Fulton, NY 13069 | 2011-11-22 |
| 1215242680 | Meghan Kathleen Hill | Physical Therapist | 706 South 4th St, Fulton, NY 13069 | 2010-08-10 |
| 1659699064 | Daniel Petrescu | Physical Therapist | 453 Park St., Michaud Residential Healthcare, Fulton, NY 13069 | 2010-05-10 |
| 1528212842 | Robyn Elizabeth Mccann | Licensed Practical Nurse | 464 Red School House Road, Fulton, NY 13069 | 2008-11-13 |
| Find all providers in zip 13069 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508464918 | Elena Carianna | Nurse Practitioner | 469 Clinton Ave Apt 1, Brooklyn, NY 11238-1732 | 2020-10-16 |
| 1265039291 | Barbara Sztukowski | Nurse Practitioner | 438 Stockholm St, Ridgewood, NY 11385-1333 | 2020-10-02 |
| 1821602814 | Rut Ester Almonte Ceron | Nurse Practitioner | 15045 73rd Ave Apt 3h, Flushing, NY 11367-2610 | 2020-09-07 |
| 1073127544 | Stacy E Garrity | Nurse Practitioner | 453 W Broadway, New York, NY 10012 | 2020-09-02 |
| 1780296434 | Ashley Leonia Valeus | Nurse Practitioner | 3415 Parsons Blvd Apt 2l, Flushing, NY 11354-4619 | 2020-08-22 |
| 1013529692 | Angelina Yushuvayev | Nurse Practitioner | 14703 77th Rd, Flushing, NY 11367-3428 | 2020-08-17 |
| 1417567942 | Amanpreet Karir | Nurse Practitioner | 1305 York Ave Ste 6, New York, NY 10021-5663 | 2020-08-10 |
| 1700495249 | Jessica Bobadilla | Nurse Practitioner | 9960 63rd Rd Apt 11w, Rego Park, NY 11374-1925 | 2020-07-30 |
| 1144844812 | Charlene Santos-alvarez | Nurse Practitioner | 8450 169th St Apt 502, Jamaica, NY 11432-2018 | 2020-05-29 |
| 1346863610 | Maria Furman | Nurse Practitioner | 130 E 93rd St Apt 5d, New York, NY 10128-1624 | 2020-05-21 |
| Find all providers with the same taxonomy | ||||
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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.