MRS. SHANNON JEANETTE CANNON (NPI# 1811294614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811294614 |
| Entity Type | Individual |
| Full Name | MRS. SHANNON JEANETTE CANNON |
| Credential | C.P.N.P. |
| Practice Address |
5207 Hickory Park Dr Suite C Glen Allen VA 23059-2624 |
| Practice Telephone | 8043778981 |
| Practice Fax Number | 8043778984 |
| Mailing Telephone | 8043778981 |
| Mailing Fax Number | 8043778984 |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2015-12-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 0001191706 | VA | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
0024167941 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396368817 | Shannon Marie Cannon | Case Manager/Care Coordinator | 1543 Summers St, Shreveport, LA 71108-3131 | 2020-05-19 |
| 1417431263 | Shannon Cannon | Registered Nurse | 600 Abbott Dr, Broomall, PA 19008-4317 | 2018-09-18 |
| 1558604512 | Shannon Cannon | Surgery | 1959 Ne Pacific St, Seattle, WA 98195-6410 | 2013-03-28 |
| Street Address |
5207 HICKORY PARK DR SUITE C |
| City | GLEN ALLEN |
| State | VA |
| Zip Code | 23059-2624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477543387 | Shelley B. Woodley | Nurse Practitioner | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2005-10-24 |
| 1568899409 | Bon Secours Virginia Medical Group I, LLC | Dermatology | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2013-10-10 |
| 1518301050 | Jason Anthony Leone | Nurse Practitioner | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2013-04-27 |
| 1063799302 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Internal Medicine | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2011-11-15 |
| 1275829673 | Allison B Trevillian | Nurse Practitioner | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2011-06-23 |
| 1629377221 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Dermatology | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2011-03-22 |
| 1972783918 | Bon Secours-virginia Healthsource | Internal Medicine | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059 | 2007-11-07 |
| 1407053713 | Aysha Habib | Internal Medicine | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2007-06-29 |
| 1720157357 | Julia K. Padgett | Dermatology | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2006-11-07 |
| 1699731554 | Jill Elaine Ryland | Pediatrics | 5207 Hickory Park Dr, Suite C, Glen Allen, VA 23059-2624 | 2006-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422163 | Kusum Bhetwal | Nurse Practitioner | 12804 Westin Estates Drive, Glen Allen, VA 23059 | 2020-09-23 |
| 1538704770 | Rise Services LLC | Community/Behavioral Health | 11357 Nuckois Road, Suite 2043, Glen Allen, VA 23059 | 2019-11-12 |
| 1992347116 | Irene Anne Mcgovern | Technician | 5233 Eastbranch Dr, Glen Allen, VA 23059 | 2019-10-09 |
| 1427547322 | Sharon Ann Lott | Audiologist | Short Pump Middle School, 4701 Pouncey Tract Road, Glen Allen, VA 23059 | 2018-05-07 |
| 1518476423 | Thomas Joseph Stein | Pharmacist | 4912 Old Millrace Place, Glen Allen, VA 23059 | 2017-09-22 |
| 1033638440 | Caroline Taylor | Specialist/Technologist | 5143 Dorin Hill Ct., Glen Allen, VA 23059 | 2017-09-18 |
| 1003335167 | Rva Transport, Inc. | Non-emergency Medical Transport (VAN) | 830 Brassie Ln, Apt F, Glen Allen, VA 23059 | 2017-09-10 |
| 1639628407 | Jessica Jasmine Green | Nurse Practitioner | 4687 Poucey Tract Road, Glen Allen, VA 23059 | 2016-09-22 |
| 1255512760 | Peggy Ellen York | Psychologist | 13314 Greenwood Rd, Glen Allen, VA 23059 | 2007-11-27 |
| 1689795940 | Kim Blassic | Dentist | 5225 Hickory Park Dr., Suite D, Glen Allen, VA 23059 | 2007-04-03 |
| Find all providers in zip 23059 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639628407 | Jessica Jasmine Green | Nurse Practitioner | 4687 Poucey Tract Road, Glen Allen, VA 23059 | 2016-09-22 |
| 1275850612 | Amy Katherine Foy | Nurse Practitioner | 5207 Hickory Park Dr Ste C, Glen Allen, VA 23059-2624 | 2010-04-26 |
| 1063505808 | Susan H. Myzer | Nurse Practitioner | 4686 Pouncey Tract Road, Glen Allen, VA 23059 | 2006-10-02 |
| 1982233136 | Nicole Ashlee Smith | Nurse Practitioner | 4687 Pouncey Tract Rd, Glen Allen, VA 23059-5802 | 2020-04-08 |
| 1558911263 | Abigail Myree Schwartz | Nurse Practitioner | 4687 Pouncey Tract Rd, Glen Allen, VA 23059-5802 | 2019-09-14 |
| 1174039358 | Rebecca Lynn Mcnicol | Nurse Practitioner | 10571 Telegraph Rd Ste 110, Glen Allen, VA 23059-4652 | 2017-12-25 |
| 1881106037 | Sarah Seiberling Fulton Barr | Nurse Practitioner | 4687 Pouncey Tract Rd, Glen Allen, VA 23059-5802 | 2017-10-27 |
| 1821532359 | Erin Marie Johnson | Nurse Practitioner | 10571 Telegraph Rd, Suite 110, Glen Allen, VA 23059-4652 | 2016-12-19 |
| 1184092389 | Tiffany Batterton | Nurse Practitioner | 4687 Pouncey Tract Rd, Glen Allen, VA 23059-5802 | 2015-09-04 |
| 1730580085 | Ann Lewis Shields | Nurse Practitioner | 4687 Pouncey Tract Rd, Glen Allen, VA 23059-5802 | 2014-09-05 |
| Find all providers in GLEN ALLEN | ||||
| City | GLEN ALLEN |
| Zip Code | 23059 |
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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.