SHANNON WITT (NPI# 1841673753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841673753 |
| Entity Type | Individual |
| Full Name | SHANNON WITT |
| Other Name | SHANNON WILSON |
| Credential | FNP |
| Practice Address |
2708 Paoli Pike Ste I New Albany IN 47150-5100 |
| Mailing Address |
1002 Catalpa Dr Georgetown IN 47122-8785 |
| Practice Telephone | 8127257894 |
| Practice Fax Number | 8125903168 |
| Mailing Telephone | 8129133818 |
| Mailing Fax Number | 8125903168 |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2019-05-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
1111715 | KY | Allopathic & Osteopathic Physicians |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
1111715 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4209 Outer Loop, Louisville, KY 402193850 | 8127257894 | 8125903168 |
| Street Address |
2708 PAOLI PIKE STE I |
| City | NEW ALBANY |
| State | IN |
| Zip Code | 47150-5100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538575584 | Odyssey Primary Care Center, LLC | Clinic/Center | 2708 Paoli Pike Ste I, New Albany, IN 47150-5100 | 2014-07-09 |
| 1134690258 | Serenity Primary Care & Recovery LLC | Family Medicine | 2708 Paoli Pike Ste I, New Albany, IN 47150-5100 | 2018-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396385050 | Essential Pediatrics | Physical Therapist | 1614 Slate Run Road, New Albany, IN 47150 | 2020-01-10 |
| 1871075234 | Katie Lyn Vincent | Speech-Language Pathologist | 845 Park Place, New Albany, IN 47150 | 2018-09-02 |
| 1326528811 | Donna Casey Laduke | Respiratory Therapist, Registered | Baptist Health Floyd, 1850 State Street, New Albany, IN 47150 | 2018-08-15 |
| 1003307232 | Shelby Paige Buffin | Social Worker | 1612 Dewey St., Bld. 6 Apt. 2, New Albany, IN 47150 | 2018-05-23 |
| 1104315902 | Whitney Nicole Malloy | Physician Assistant | 2108 State Street, New Albany, IN 47150 | 2018-05-07 |
| 1942728472 | Cleanse Clinic Jeffersonville LLC | Psychiatry & Neurology | 2818 Grant Line Rd Ste 2, New Albany, IN 47150 | 2017-09-05 |
| 1881110765 | Kristy Marie Delaney | Social Worker | 1144 Creekview Circle, New Albany, IN 47150 | 2017-08-22 |
| 1891217030 | Sarah H. Wilson | Physician Assistant | 1919 State St Ste 362, New Albany, IN 47150 | 2017-07-10 |
| 1861939290 | Lauren Brenneman Pollock | Audiologist | 3211 Grant Line Rd St. #37, New Albany, IN 47150 | 2017-01-24 |
| 1861850414 | Kiley Madaleno | Speech-Language Pathologist | 4915 Charlestown Road, New Albany, IN 47150 | 2016-02-10 |
| Find all providers in zip 47150 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255617973 | Shelia A Sancillo Tice | Nurse Practitioner | 456 W Bankhead St, New Albany, MS 38652-3319 | 2011-10-26 |
| 1750838066 | Jalyn Goolsby | Nurse Practitioner | 2585 Charlestown Rd, New Albany, IN 47150-2553 | 2016-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942809140 | Indiana Suburban Visiting Physician Services | Nurse Practitioner | 5 Washington St Ste 300, Valparaiso, IN 46383-4769 | 2020-10-20 |
| 1033737069 | Housecalls/optum for United Health Group | Nurse Practitioner | 518 Euclid Ave, Greenwood, IN 46142-3618 | 2020-07-07 |
| 1497382030 | Toya Jamillah Woods | Nurse Practitioner | 3814 Grant St, Gary, IN 46408-2150 | 2020-03-24 |
| 1558905554 | Amy Hueston | Nurse Practitioner | 313 S Berkley Rd, Kokomo, IN 46901-5114 | 2019-11-01 |
| 1891338166 | Jayme Lantz | Nurse Practitioner | 20085 Turquoise Ln, Goshen, IN 46528-6294 | 2019-10-19 |
| 1033761770 | Workplace Health Services | Nurse Practitioner | 1632 W. In-28, Frankfort, IN 46041 | 2019-07-12 |
| 1164984597 | Care At Home LLC | Nurse Practitioner | 717 Washington Park Blvd, Michigan City, IN 46360-2056 | 2019-04-04 |
| 1255815379 | Amanda Kay Goins | Nurse Practitioner | 3919 W Jefferson Blvd Ste B, Fort Wayne, IN 46804-6811 | 2018-09-25 |
| 1972084267 | Kelly Sue Ann Peasley | Nurse Practitioner | 2101 Jackson St Ste 8, Anderson, IN 46016-4341 | 2018-08-24 |
| 1891271466 | Hilton Health Housecall LLC | Nurse Practitioner | 4340 Trace Wood Dr, Indianapolis, IN 46254-6238 | 2018-07-17 |
| Find all providers with the same taxonomy | ||||
| City | NEW ALBANY |
| Zip Code | 47150 |
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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.