KRISTA E. SHACKELFORD (NPI# 1922038801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922038801 |
| Entity Type | Individual |
| Full Name | KRISTA E. SHACKELFORD |
| Credential | M.D. |
| Practice Address |
835 N Hillside St Wichita KS 67214-4913 |
| Practice Telephone | 3166854395 |
| Practice Fax Number | 3166851149 |
| Mailing Telephone | 3166854395 |
| Mailing Fax Number | 3166851149 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2008-04-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 0432039 | KS | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 01061838A | IN | Allopathic & Osteopathic Physicians |
| Street Address |
835 N HILLSIDE ST |
| City | WICHITA |
| State | KS |
| Zip Code | 67214-4913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508848144 | Martha S Housholder | Dermatology | 835 N Hillside St, Wichita, KS 67214-4913 | 2005-11-18 |
| 1346754199 | Megan Christine Holick | Physician Assistant | 835 N Hillside St, Wichita, KS 67214-4913 | 2017-11-30 |
| 1932168317 | The Dermatology Clinic, P A | Dermatology | 835 N Hillside St, Wichita, KS 67214-4913 | 2006-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124591185 | Laquita Patrice Boyede | Durable Medical Equipment & Medical Supplies | 1503 Northeast Parkway, Wichita, KS 67214 | 2019-01-02 |
| 1891270674 | Kathryn Denise Boomer | Physician Assistant | 929 St. Francis N, Wichita, KS 67214 | 2018-09-27 |
| 1447756457 | Cardinal Health 132 LLC | Pharmacy | 527 N Grove Street, Suite 100, Wichita, KS 67214 | 2018-03-30 |
| 1023517174 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 3243 E Murdock Street, Level G, Wichita, KS 67214 | 2018-02-05 |
| 1558887901 | Shonnetta Lachan Gabriel | Counselor | 2707 E. 21st St. N, Wichita, KS 67214 | 2017-08-17 |
| 1417492174 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 803 N Broadway Ave, Wichita, KS 67214 | 2017-01-04 |
| 1952850653 | Rachel J Johnson | Counselor | 805 N Volutsia, Wichita, KS 67214 | 2016-09-23 |
| 1063899813 | Christy Lee Foos | Social Worker | 2707 E. 21st St. North, Healthcore Clinic, Wichita, KS 67214 | 2015-04-30 |
| 1952708018 | William Schroeder Fargo | Specialist | 701 N. Emporia, Wichita, KS 67214 | 2014-12-04 |
| 1447692710 | Valeriya V Hunter | Dentist | 527 N Grove, Wichita, KS 67214 | 2013-07-26 |
| Find all providers in zip 67214 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346478054 | Landon M Johnson | Dermatology | 1911 North Webb Rd, Wichita, KS 67206 | 2009-07-01 |
| 1891798005 | Christopher A Moeller | Dermatology | 1911 N Webb Rd, Wichita, KS 67206-3405 | 2005-05-23 |
| 1184256844 | Wichita Dermatology,llc | Dermatology | 1911 North Webb Rd, Wichita, KS 67206 | 2020-02-10 |
| 1619297769 | Brandon Litzner | Dermatology | 1861 N Rock Rd Ste 310, Wichita, KS 67206-1264 | 2010-06-10 |
| 1710915210 | Stanley L Capper | Dermatology | 9211 E 21st St N, Wichita, KS 67206-2968 | 2006-06-30 |
| 1710914197 | John C Robichaux | Dermatology | 9211 E 21st St N, Wichita, KS 67206-2968 | 2006-06-28 |
| 1285685008 | Mid-kansas Dermatology Clinic, Pa | Dermatology | 1861 N Rock Rd, Suite 310, Wichita, KS 67206-4200 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615648 | Lori E Falcone | Dermatology | 1121 N College Park St Ste 400, Derby, KS 67037-3667 | 2020-10-06 |
| 1710444500 | Epiphany Dermatology of Kansas, LLC | Dermatology | 10600 Quivira Rd Ste 430, Overland Park, KS 66215-2312 | 2019-02-27 |
| 1104354794 | Blue Valley Dermatology | Dermatology | 7840 W 165th Street, Suite 260, Overland Park, KS 66223 | 2017-05-26 |
| 1346618220 | Tara Gillespie | Dermatology | 2707 Vine St Ste 10, Hays, KS 67601-1908 | 2015-09-09 |
| 1295072163 | Bernard James Melia Jr. | Dermatology | 5418 W 100th St, Overland Park, KS 66207-3116 | 2013-01-11 |
| 1134481831 | Johanna Suzanne Peterson | Dermatology | 3901 Rainbow Blvd. 6040 Delp, Ms1020, Division of General and Geriatric Medicine, University, Kansas City, KS 66160-0001 | 2012-06-09 |
| 1780950352 | Jacqueline Margaret Youtsos | Dermatology | 2425 Bradshaw Way, Pittsburg, KS 66762-6600 | 2012-03-28 |
| 1760709679 | Lauren Ann Kyle Tkachuk | Dermatology | 7840 W 165th St Ste 260, Overland Park, KS 66223-3020 | 2010-05-02 |
| 1639494198 | Anand Rajpara | Dermatology | 3901 Rainbow Blvd # Ms 2025, Kansas City, KS 66160 | 2010-03-28 |
| 1578792776 | Tracy Michelle Katz | Dermatology | Ms 2025 4009 Wescoe, 3901 Rainbow Blvd., Kansas City, KS 66160-0001 | 2009-07-08 |
| Find all providers with the same taxonomy | ||||
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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.