SHANNON MARIE JOHNSON WILDER (NPI# 1972131621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972131621 |
Entity Type | Individual |
Full Name | SHANNON MARIE JOHNSON WILDER |
Other Name | SHANNON MARIE JOHNSON |
Credential | PH.D. |
Practice Address |
2200 Sw Gage Blvd Topeka KS 66622-0001 |
Practice Telephone | 7853503111 |
Enumeration Date | 2020-03-30 |
Last Update Date | 2020-03-30 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
377657 | WI | Behavioral Health & Social Service Providers |
Street Address |
2200 SW GAGE BLVD |
City | TOPEKA |
State | KS |
Zip Code | 66622-0001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811994395 | Jeffrey M Warner | Chiropractor | 2200 Sw Gage Blvd, Topeka, KS 66622-0001 | 2005-06-30 |
1063034486 | Margaret Ellen Anderson | Occupational Therapist | 2200 Sw Gage Blvd, Topeka, KS 66622-0001 | 2020-05-07 |
1053949255 | Dawn A Garcia | Registered Nurse | 2200 Sw Gage Blvd, Topeka, KS 66622-0001 | 2020-04-01 |
1902432412 | Leasha Raelynn Brooks | Family Medicine | 2200 Sw Gage Blvd, Topeka, KS 66622-0001 | 2020-03-16 |
1275169898 | Andrea Leigh Orrison | Nurse Practitioner | 2200 Sw Gage Blvd, Topeka, KS 66622-0001 | 2020-03-15 |
1922633718 | Cecilia Adaora Nwakpuda | Nurse Practitioner | 2200 Sw Gage Blvd, Topeka, KS 66622-0001 | 2020-03-11 |
1144869025 | Jayme M Mavrovich | Social Worker | 2200 Sw Gage Blvd, Topeka, KS 66622-0001 | 2019-12-25 |
1699313882 | Shawna R Deters | Registered Nurse | 2200 Sw Gage Blvd, Topeka, KS 66622-0001 | 2019-12-18 |
1407400526 | Debra M. Crater | Social Worker | 2200 Sw Gage Blvd, Topeka, KS 66622-0001 | 2019-07-26 |
1609428838 | Melissa Hinrichsen | Pharmacist | 2200 Sw Gage Blvd, Topeka, KS 66622-0001 | 2019-07-09 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255823001 | Tara Jarrett | Psychologist | 2200 Sw Gage Blvd., Topeka, KS 66622 | 2018-06-06 |
1750321519 | Jamye Buelke Brown | Psychologist | Colmery-o'neil Va Medical Center, 2200 Gage Boulevard, Topeka, KS 66622 | 2006-06-08 |
1003864026 | Richard Guy Brausa | Social Worker | Ekhcs 2200 Gage, Topeka, KS 66622 | 2006-05-04 |
1174580625 | Sandra Lynn Hampton | Physician Assistant | 2200 Gage Va, Topeka, KS 66622 | 2006-04-27 |
1790741882 | Jose Maria Bejar | Psychiatry & Neurology | 2200 Gage Blvd., Topeka, KS 66622 | 2006-04-26 |
1750877635 | Kiran Randhawa | Psychiatry & Neurology | 2200 Sw Gage Blvd., Topeka, KS 66622 | 2018-07-03 |
1427089879 | Laura Leanne Rupnick | Pharmacist | Colmery-o'neil Va Medical Center, 2200 Gage Blvd, Topeka, KS 66622 | 2006-07-05 |
1457382673 | Patricia J Mcnelis | Nurse Practitioner | 2200 Gage Blvd, Colmeny Oneil Va Medical Center, Topeka, KS 66622 | 2006-07-05 |
1962416909 | Jay Pehrson Kennedy | Family Medicine | 2200 Sw Gage Boulevard, U.S. Department of Veterans Affairs, Topeka, KS 66622-0000 | 2006-07-27 |
1821588526 | Cody Poell | Pharmacist | 2200 Seems Gage Blvd, Topeka, KS 66622-0001 | 2018-05-17 |
Find all providers in zip 66622 |
Taxonomy Code | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265709026 | Optimum Performance Solutions, LLC | Psychologist | 2709 Sw 29th St, Suite 102, Topeka, KS 66614-2085 | 2011-11-22 |
1841501707 | Dana Marie Thomas | Psychologist | 3448 Se 35th St, Topeka, KS 66605-3102 | 2010-06-25 |
1255591210 | Jessica Paige Snyder | Psychologist | 815 Se Rice Rd, Topeka, KS 66607-2354 | 2008-06-12 |
1902999089 | Sallye M. Wilkinson | Psychologist | 1508 Sw Topeka Blvd, Topeka, KS 66612-1887 | 2006-10-02 |
1265544233 | Jennifer Marie Grosskreutz | Psychologist | 327 Sw Frazier Ave, Topeka, KS 66606-1963 | 2006-08-31 |
1922117183 | James Randall Eyman | Psychologist | 2955 Sw Wanamaker Drive, Topeka, KS 66614 | 2006-08-30 |
1922115922 | Elizabeth A Ohse | Psychologist | 629 Se Quincy St, Suite 103, Topeka, KS 66603-3921 | 2006-08-24 |
1215957840 | Thomas V Matthews | Psychologist | 2709 Sw 29th St # 102, Topeka, KS 66614-2085 | 2006-07-19 |
1336751296 | Callie Ferguson | Psychologist | 4101 Sw Martin Dr Ste B, Topeka, KS 66609-1221 | 2020-08-20 |
1023512712 | Jasmine Bene Harris | Psychologist | 2200 Sw Gage Blvd, Topeka, KS 66622-0001 | 2018-03-19 |
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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.