MISS SHANNON KATHLEEN KELLY (NPI# 1831751262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831751262 |
| Entity Type | Individual |
| Full Name | MISS SHANNON KATHLEEN KELLY |
| Credential | PA-C |
| Practice Address |
5800 Central Gardens Way Apt 204 Palm Beach Gardens FL 33418-4125 |
| Practice Telephone | 5614278799 |
| Mailing Telephone | 5614278999 |
| Enumeration Date | 2019-07-06 |
| Last Update Date | 2020-07-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCCPA ID | 1148870 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 252 S 4th St, Lebanon, PA 170426111 | 7172707500 | |
| 6103 Winding Lake Dr, Jupiter, FL 334583762 | 5614278799 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699268821 | Shannon Marie Kelly | Dentist | 200 N Royal Tower Dr, Irmo, SC 29063 | 2018-06-12 |
| 1578991790 | Shannon Kelly | Pharmacist | 2792 Lea Lake Rd, Blaine, TN 37709-5214 | 2013-10-25 |
| 1144483421 | Shannon Elizabeth Kelly | Counselor | 115 E Costilla St, Colorado Springs, CO 80903-2101 | 2008-07-07 |
| 1457313330 | Shannon Kelly | Psychologist | 6001 Brick Ct, Suite 201, Winter Park, FL 32792-9425 | 2006-04-05 |
| 1619593241 | Shannon Marie Kelly | Registered Nurse | 3400 N Woods Ln, Rogers, AR 72756-6712 | 2020-06-19 |
| 1366929747 | Shannon Kelly | Social Worker | 1400 Vfw Pkwy, West Roxbury, MA 02132-4927 | 2018-07-27 |
| 1679084172 | Shannon Marie Kelly | Speech-Language Pathologist | 900 Washington Ave Ste 602, Waco, TX 76701-1283 | 2017-10-24 |
| 1508306309 | Shannon Kelly | Physician Assistant | 159 E 74th St, Second Floor, New York, NY 10021-3235 | 2017-02-28 |
| 1821535741 | Shannon Kelly | Occupational Therapist | 6960 Destiny Dr Ste 112, Rocklin, CA 95677-2995 | 2017-01-30 |
| 1194172668 | Shannon Allison Kelly | Pharmacist | 226 Se 8th Ave, Hillsboro, OR 97123-4218 | 2016-05-15 |
| Street Address |
5800 CENTRAL GARDENS WAY APT 204 |
| City | PALM BEACH GARDENS |
| State | FL |
| Zip Code | 33418-4125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265031447 | Jorge Wilfrido Avila | Psychiatry & Neurology | 118 Emerald Key Ln., Palm Beach Gardens, FL 33418 | 2020-10-20 |
| 1518438852 | Jessica E Harrison, Lcsw | Clinic/Center | 900 East Indiantown Road, 310, Palm Beach Gardens, FL 33418 | 2018-12-16 |
| 1275000879 | Dentists of Palm Beach Gardens, Pa | Dentist | 5380 Donald Ross, Rd., Suite 100, Palm Beach Gardens, FL 33418 | 2018-11-01 |
| 1861979932 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 5410 Donald Ross Rd, Palm Beach Gardens, FL 33418 | 2018-07-23 |
| 1194240150 | Private Home Care LLC | Home Health | 5211 Celery Ln, Palm Beach Gardens, FL 33418 | 2017-08-10 |
| 1053836791 | Ashley Mooney | Pharmacist | 6251 Ave of The Pga, Palm Beach Gardens, FL 33418 | 2017-08-03 |
| 1063950343 | Spinal Motion Diagnostics Fort Lauderdale LLC | Clinic/Center | 8435 Man O War Road, Palm Beach Gardens, FL 33418 | 2017-02-07 |
| 1588108823 | Fernando Javier Rodriguez | Pharmacist | 290 Woodbine Way, Apt 215, Riviera Beach, FL 33418 | 2016-12-06 |
| 1811430036 | Lauren Alexandra Kratofil | Physical Therapist | 300 Avenue of The Champions, Palm Beach Gardens, FL 33418 | 2016-11-19 |
| 1417403221 | Ahava-5772, LLC | Chiropractor | 5540 Pga Boulevard, Suite 100, Palm Beach Gardens, FL 33418 | 2016-08-31 |
| Find all providers in zip 33418 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013413459 | Mobile Med, LLC | Physician Assistant | 3000 Central Gardens Cir, Palm Beach Gardens, FL 33418-8700 | 2018-04-04 |
| 1598002461 | Patrick Alen Willett | Physician Assistant | 4215 Burns Rd Ste 100, Palm Beach Gardens, FL 33410-4627 | 2013-01-11 |
| 1447597620 | Leslye Vanessa Canas | Physician Assistant | 1316 Sonoma Ct, Palm Beach Gardens, FL 33410-1517 | 2013-01-08 |
| 1184945636 | Bryant Alexandra Meyer | Physician Assistant | 2465 San Pietro Circle, Palm Beach Gardens, FL 33410 | 2010-06-18 |
| 1689763666 | Richard Matthew Garibaldi | Physician Assistant | 3401 Pga Blvd Ste 325, Palm Beach Gardens, FL 33410-2898 | 2006-10-11 |
| 1922051770 | Lori Beth Oswald | Physician Assistant | 11020 Rca Center Dr Ste 2010, Palm Beach Gardens, FL 33410-4277 | 2006-05-19 |
| 1407349384 | Shayna Fasanella | Physician Assistant | 5540 Pga Blvd Ste 200, Palm Beach Gardens, FL 33418-3987 | 2018-06-14 |
| 1851699698 | Marianne Pineda | Physician Assistant | 600 Village Square Xing, Palm Beach Gardens, FL 33410-4543 | 2011-03-02 |
| 1386899250 | Patricia Lynn Tucker | Physician Assistant | 3345 Burns Rd Ste 302, Palm Beach Gardens, FL 33410-4321 | 2008-11-19 |
| 1811181274 | Lisa Susan Joyce | Physician Assistant | 3401 Pga Blvd Ste 310, Palm Beach Gardens, FL 33410-2824 | 2007-08-29 |
| Find all providers in PALM BEACH GARDENS | ||||
| City | PALM BEACH GARDENS |
| Zip Code | 33418 |
Please comment or provide details below to improve the information on MISS SHANNON KATHLEEN KELLY.
| 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.