SHANNA KIDD (NPI# 1851616916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851616916 |
| Entity Type | Individual |
| Full Name | SHANNA KIDD |
| Other Name | SHANNA JO WHEATLEY |
| Credential | PA-C |
| Practice Address |
701 W 5th St Odessa TX 79763-4206 |
| Mailing Address |
701 W 5th St Suite 1c34 Odessa TX 79763-4206 |
| Practice Telephone | 4323351500 |
| Practice Fax Number | 4323351537 |
| Mailing Telephone | 4323355126 |
| Mailing Fax Number | 4323351807 |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2010-11-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA06691 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
701 W 5TH ST |
| City | ODESSA |
| State | TX |
| Zip Code | 79763-4206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407845084 | Texas Tech University Health Sciences Center Odessa | Internal Medicine | 701 W 5th St, Odessa, TX 79763-4206 | 2005-10-17 |
| 1568075117 | Bibek Bakhati | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2020-08-24 |
| 1972112852 | Priya Darshini Velumani | Internal Medicine | 701 W 5th St, Odessa, TX 79763-4206 | 2020-07-28 |
| 1811505274 | Hina Tariq | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2020-07-21 |
| 1710595350 | Prince Richardson Lemuel Ernest | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2020-07-20 |
| 1952939951 | Goutami Mangu | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2020-03-27 |
| 1790337483 | Mandeep Kaur Sidhu | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2019-07-12 |
| 1174185292 | Andrey Mironenko | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2019-06-29 |
| 1043872120 | Govind Jha | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2019-06-28 |
| 1447811682 | Juan Guillermo Sierra David | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2019-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164885 | Mary Ewusie | Pharmacist | 2450 West Loop 3378, Odessa, TX 79763 | 2020-11-03 |
| 1982231569 | Yashica Patel | Student in an Organized Health Care Education/Training Program | 701 W. 5th St, Suite 1229, Odessa, TX 79763 | 2020-03-24 |
| 1144740457 | Devi Priya Suravajjala | Student in an Organized Health Care Education/Training Program | 701,w 5th Street, Odessa, TX 79763 | 2017-06-27 |
| 1649640392 | Elesea Celeste Villegas | Physician Assistant | 701 West 5th Street, Odessa, TX 79763 | 2015-10-06 |
| 1790046472 | Kathryn Nichole Hutton | Obstetrics & Gynecology | 701 W 5th Street, Odessa, TX 79763 | 2012-05-30 |
| 1962761791 | Marvin Ryan Harvey | Family Medicine | 701 W 5th St Ste 3174, Odessa, TX 79763 | 2012-05-14 |
| 1245529544 | Yvette Garcia | Counselor | 1012 W Macarthur, Odessa, TX 79763 | 2011-04-07 |
| 1386973873 | Patty Denise Pena | Pharmacist | 1305 W County Rd, Odessa, TX 79763 | 2009-12-14 |
| 1508002262 | Javier E Espinoza | Physician Assistant | 1220 W. University, Odessa, TX 79763 | 2008-12-31 |
| 1952584690 | J A Mayans Md Pa | Ophthalmology | 907 W Second St, Odessa, TX 79763 | 2007-12-17 |
| Find all providers in zip 79763 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891234969 | Jesus Mendez Fuentes | Physician Assistant | 2224 Alameda Ct, Odessa, TX 79763-2273 | 2017-02-22 |
| 1649640392 | Elesea Celeste Villegas | Physician Assistant | 701 West 5th Street, Odessa, TX 79763 | 2015-10-06 |
| 1184022758 | Md Moinul Islam | Physician Assistant | 6030 W. University, Odessa, TX 79764 | 2014-12-15 |
| 1962711200 | Ramnauth Robert Ramkissoon | Physician Assistant | 1940 E 42nd St Ste B, Odessa, TX 79762-5840 | 2010-10-05 |
| 1629304811 | Erika Alfaro Salvo | Physician Assistant | 4222 Wendover Ave Ste 600, Odessa, TX 79762-5983 | 2009-10-23 |
| 1508002262 | Javier E Espinoza | Physician Assistant | 1220 W. University, Odessa, TX 79763 | 2008-12-31 |
| 1679511802 | J David Barr | Physician Assistant | 16734 Ivy Lake Dr, Odessa, FL 33556-6020 | 2006-06-02 |
| 1275171423 | Kailani Alana Lee Decock | Physician Assistant | 520 E 6th St, Odessa, TX 79761-4527 | 2019-12-18 |
| 1255986402 | Alexandra R Fierro | Physician Assistant | 720 Golder Ave, Odessa, TX 79761-4442 | 2019-08-05 |
| 1538714076 | Stephanie Renee' Powell | Physician Assistant | 520 E 6th St, Odessa, TX 79761-4527 | 2019-08-01 |
| Find all providers in ODESSA | ||||
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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.