MS. SHANNON LOFTIS (NPI# 1972557221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972557221 |
| Entity Type | Individual |
| Full Name | MS. SHANNON LOFTIS |
| Credential | PAC |
| Practice Address |
1155 N Mayfair Rd Plank Road Clinic Milwaukee WI 53226-3421 |
| Practice Telephone | 4149555990 |
| Practice Fax Number | 4149556282 |
| Mailing Telephone | 4149555990 |
| Mailing Fax Number | 4149556282 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2014-08-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 928-023 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1972557221 | 05 | |
| HUMANA | 008000315Q | 01 |
| Street Address |
1155 N MAYFAIR RD PLANK ROAD CLINIC |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53226-3421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801873245 | Christina L Wichman | Psychiatry & Neurology | 1155 N Mayfair Rd, Department of Psychiatry, Milwaukee, WI 53226-3462 | 2005-12-28 |
| 1184128381 | Shannon M Friedbacher | Psychiatry & Neurology | 1155 N Mayfair Rd, Milwaukee, WI 53226-3462 | 2018-03-21 |
| 1003326745 | Kevin Bozymski | Pharmacist | 1155 N Mayfair Rd, Milwaukee, WI 53226-3462 | 2017-10-09 |
| 1770008492 | Judith Ann Evenson | Nurse Practitioner | 1155 N Mayfair Rd, Milwaukee, WI 53226-3462 | 2017-08-03 |
| 1760914378 | Miles Bichanich | Plastic Surgery | 1155 N Mayfair Rd, Ste. T2600- South Entry, Milwaukee, WI 53226-3462 | 2017-04-02 |
| 1669913034 | Jennifer Orth | Occupational Therapist | 1155 N Mayfair Rd, Milwaukee, WI 53226-3462 | 2017-03-17 |
| 1093255549 | Legenda Gooding | Nurse Practitioner | 1155 N Mayfair Rd, Suite 1, Milwaukee, WI 53226-3462 | 2017-03-02 |
| 1932657699 | Tera Carman | Social Worker | 1155 N Mayfair Rd, Department of Psychiatry, Milwaukee, WI 53226-3462 | 2016-09-12 |
| 1689120982 | Froedtert & The Medical College of Wisconsin Community Physicians, Inc | Durable Medical Equipment & Medical Supplies | 1155 N Mayfair Rd, Milwaukee, WI 53226-3462 | 2016-08-28 |
| 1275997645 | Amanda Liewen | Psychiatry & Neurology | 1155 N Mayfair Rd, Milwaukee, WI 53226-3462 | 2016-04-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
| 1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
| 1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
| 1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
| 1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
| 1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
| Find all providers in zip 53226 | ||||
| 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 |
|---|---|---|---|---|
| 1386257194 | Harrison R Pham | Physician Assistant | 214 E Florida St Apt 526, Milwaukee, WI 53204-1657 | 2020-08-31 |
| 1942824602 | Rebecca Frances Hasler | Physician Assistant | 2368 N Humboldt Blvd, Milwaukee, WI 53212-3524 | 2020-05-28 |
| 1194355784 | Ashley Bishop Henning | Physician Assistant | 2350 N Lake Dr Ste 404, Milwaukee, WI 53211-4528 | 2020-01-22 |
| 1902457575 | Kathryn Kasper | Physician Assistant | 2408 N Buffum St, Milwaukee, WI 53212-2902 | 2019-09-25 |
| 1972151314 | Kelly J Meyer | Physician Assistant | 2900 W Oklahoma Ave Ste 414, Milwaukee, WI 53215-4330 | 2019-08-28 |
| 1659923795 | Mikayla Preissner | Physician Assistant | 788 N Jefferson St Ste 401, Milwaukee, WI 53202-3718 | 2019-07-09 |
| 1245892124 | Emily Mason | Physician Assistant | 2901 W Kk River Pkwy Ste 507, Milwaukee, WI 53215-3660 | 2019-07-01 |
| 1124513528 | Kirby Kristine Hancock | Physician Assistant | 2350 N Lake Dr Ste 302, Milwaukee, WI 53211-4528 | 2018-06-27 |
| 1548785785 | Anne Gustavson | Physician Assistant | 5500 W Brown Deer Rd Ste 400, Milwaukee, WI 53223-2265 | 2017-08-09 |
| 1205359973 | Christina Marie Rende | Physician Assistant | 2350 N Lake Dr Ste 206, Milwaukee, WI 53211-4528 | 2017-07-24 |
| Find all providers in MILWAUKEE | ||||
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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.