MR. SHANNON E PHILLIPS JR. (NPI# 1811969165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811969165 |
| Entity Type | Individual |
| Full Name | MR. SHANNON E PHILLIPS JR. |
| Credential | N.P. |
| Practice Address |
116 N. Houston St. Edgewood TX 75117 |
| Mailing Address |
P.o. Box 76 Canton TX 75103 |
| Practice Telephone | 9039623419 |
| Practice Fax Number | 9033853340 |
| Mailing Telephone | 9039623419 |
| Mailing Fax Number | 9033853340 |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2020-09-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
669011 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528531845 | Shannon Phillips | Technician | 215 Fitchburg St Sw, Palm Bay, FL 32908-1302 | 2019-01-09 |
| 1861962656 | Shannon Phillips | Speech-Language Pathologist | 2119 Pocomoke Beltway, Pocomoke City, MD 21851-3025 | 2018-12-05 |
| 1598268716 | Shannon Phillips | Nutritionist | 3687 E Geddes Ave, Centennial, CO 80122-2202 | 2018-03-14 |
| 1366864381 | Shannon Phillips | Rehabilitation Practitioner | 935 Cantabria Heights Ave, Las Vegas, NV 89183-4646 | 2014-01-10 |
| 1134669401 | Shannon Phillips | Social Worker | 303 N Madison St, Corinth, MS 38834-5072 | 2017-03-06 |
| 1447607668 | Shannon Phillips | Case Manager/Care Coordinator | 10 Meadowbrook Rd, Brockton, MA 02301-7122 | 2016-05-17 |
| 1245696228 | Shannon Phillips | Nurse Practitioner | 1701 S Florissant Rd, Saint Louis, MO 63121-1131 | 2016-01-06 |
| 1679949648 | Shannon Phillips | Physician Assistant | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2015-08-13 |
| 1710258678 | Shannon Elizabeth Phillips | Counselor | 2638 Two Notch Rd, Suite 106, Columbia, SC 29204-1454 | 2012-01-24 |
| 1952671927 | Shannon Phillips | Counselor | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2012-01-09 |
| Street Address |
116 N. HOUSTON ST. |
| City | EDGEWOOD |
| State | TX |
| Zip Code | 75117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871909275 | Edgewood Rural Healthh Clinic | Family Medicine | 106 East Pine Street, Edgewood, TX 75117 | 2014-07-07 |
| 1790910263 | Edith Head | Physical Therapist | 108 N Houston, Edgewood, TX 75117 | 2009-05-27 |
| 1457493769 | Edgewood Isd | Local Education Agency (LEA) | 804 East Pine St, Edgewood, TX 75117 | 2007-02-13 |
| 1740512417 | Dana Hullum | Speech-Language Pathologist | 108 N Houston, Edgewood, TX 75117 | 2010-02-05 |
| 1366585218 | Yvonne Carol Dixon | Licensed Vocational Nurse | 608 N Houston St, Edgewood, TX 75117-2303 | 2007-02-14 |
| 1912407677 | Frances Mae Cornwell | Licensed Vocational Nurse | 303 Bowie St, Edgewood, TX 75117-2347 | 2018-02-19 |
| 1861714628 | Gober LLC | Occupational Therapist | 108 N Houston St, Edgewood, TX 75117-2500 | 2010-02-22 |
| 1972687614 | Edgewood Drug Inc | Pharmacy | 115 N Houston St, Edgewood, TX 75117-2502 | 2006-10-25 |
| 1588164115 | Cindy Rea Wilhite | Licensed Vocational Nurse | 104 Johnson St, Edgewood, TX 75117-2708 | 2018-02-20 |
| 1659773828 | Wal-mart Stores Texas LLC | Durable Medical Equipment & Medical Supplies | 504 W Pine St, Edgewood, TX 75117-2944 | 2014-09-19 |
| Find all providers in zip 75117 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295333219 | Kiersten Proctor | Nurse Practitioner | 20 Medical Village Dr Ste 102, Edgewood, KY 41017-3490 | 2020-10-12 |
| 1598381048 | Temitayo Bosede Olaniyi | Nurse Practitioner | 2203 Philadelphia Rd, Edgewood, MD 21040-1109 | 2020-06-21 |
| 1306264296 | Frederick H Blodgett | Nurse Practitioner | 7 Municpal Way, Edgewood, NM 87015-7086 | 2014-03-28 |
| 1194154823 | Vivienne Prinz | Nurse Practitioner | 104 Quail Trl, Unit B, Edgewood, NM 87015-7185 | 2013-11-04 |
| 1932277514 | Beth B Vanairsdale | Nurse Practitioner | 521 Gerhard Dr, Edgewood, KY 41017-3284 | 2006-12-01 |
| 1831198126 | Laura M Greene | Nurse Practitioner | 483 S Loop Rd, Edgewood, KY 41017-5446 | 2005-07-19 |
| 1386251957 | Cierra Dorado | Nurse Practitioner | 104 Quail Trl, Edgewood, NM 87015-7185 | 2020-09-28 |
| 1164037784 | Elizabeth Spray | Nurse Practitioner | 1 Medical Village Dr, Edgewood, KY 41017-3403 | 2020-09-10 |
| 1205459369 | Thu Thanh Nguyen | Nurse Practitioner | 104 Quail Trail, Unit B, Edgewood, NM 87015 | 2020-05-24 |
| 1295385870 | Joan Kariuki | Nurse Practitioner | 1952 Pulaski Hwy, Edgewood, MD 21040-1658 | 2019-09-16 |
| Find all providers in EDGEWOOD | ||||
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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.