Shannon R Vaughn (NPI# 1306006929, PAC ID# 1254406507) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1306006929 |
| PAC ID by PECOS | 1254406507 |
| Professional Enrollment ID | I20080820000649 |
| Full Name | Shannon R Vaughn |
| Organization Legal Name | ST LUKES CLINIC-TREASURE VALLEY LLC |
| Address |
1210 Nw 16th St Fruitland ID 83619-2202 |
| Phone Number | 2084528600 |
| Gender | F |
| Graduation Year | 2008 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4981878402 |
| Number of Group Practice Members | 770 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130006 | ST LUKE'S REGIONAL MEDICAL CENTER |
| 130071 | ST LUKE'S NAMPA MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 100 E Bannock St, Boise, ID 83712-6241 | 2083812983 | ST LUKES CLINIC-TREASURE VALLEY LLC |
| 190 E Bannock St, Boise, ID 83712-6241 | 2083819384 | ST LUKES CLINIC-TREASURE VALLEY LLC |
| 608 W Hays St, Boise, ID 83702-5511 | 2083815970 | ST LUKES CLINIC-TREASURE VALLEY LLC |
| 610 W Hays St, Boise, ID 83702-5511 | ST LUKES CLINIC-TREASURE VALLEY LLC | |
| 1210 Nw 16th St, Fruitland, ID 83619-2202 | 2084528600 | ST LUKES CLINIC-TREASURE VALLEY LLC |
| 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2083643000 | ST LUKES CLINIC-TREASURE VALLEY LLC |
| 9850 St Lukes Dr, Nampa, ID 83687-7912 | ST LUKES CLINIC-TREASURE VALLEY LLC |
| Organization Legal Name | ST LUKES CLINIC-TREASURE VALLEY LLC |
| Physicians | 831 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eric Scholten | Pulmonary Disease | St Lukes Clinic-treasure Valley LLC | 1210 Nw 16th St, Fruitland, ID 83619-2202 |
| Tracye J Lawyer | Orthopedic Surgery | St Lukes Clinic-treasure Valley LLC | 9850 St Lukes Dr, Suite 215, Nampa, ID 83687-7912 |
| Alex Mari Tanabe | Internal Medicine | St Lukes Clinic-treasure Valley LLC | 600 N Robbins Rd, Boise, ID 83702-4565 |
| Jessica J Carpenter | Clinical Social Worker | St Lukes Clinic-treasure Valley LLC | 1620 S Kimball Ave, Caldwell, ID 83605-4547 |
| Whitney B Conrad | Nurse Practitioner | St Lukes Clinic-treasure Valley LLC | 1226 W River St, Boise, ID 83702-7049 |
| Megan D Larson | Nurse Practitioner | St Lukes Clinic-treasure Valley LLC | 287 W Jefferson St, Boise, ID 83702-6045 |
| Bonnie M Reed | Family Medicine | St Lukes Clinic-treasure Valley LLC | 3090 E Gentry Way, Suite 200, Meridian, ID 83642-3550 |
| Scott J Chyna | Clinical Social Worker | St Lukes Clinic-treasure Valley LLC | 703 S Americana Blvd, Suite 150, Boise, ID 83702-4976 |
| Sarah J Mooseau | Qualified Audiologist | St Lukes Clinic-treasure Valley LLC | 510 N 2nd St, Suite 201, Boise, ID 83702-6078 |
| Nitya Alluri | Hematology | St Lukes Clinic-treasure Valley LLC | 100 E Idaho St, Suite 302, Boise, ID 83712-6269 |
| Street Address |
1210 NW 16TH ST |
| City | FRUITLAND |
| State | ID |
| Zip | 83619-2202 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eric Scholten | Pulmonary Disease | St Lukes Clinic-treasure Valley LLC | 1210 Nw 16th St, Fruitland, ID 83619-2202 |
| Brett C Johnson | Family Medicine | St Lukes Clinic-treasure Valley LLC | 1210 Nw 16th St, Fruitland, ID 83619-2202 |
| Wendi M Norris | Pulmonary Disease | St Lukes Clinic-treasure Valley LLC | 1210 Nw 16th St, Fruitland, ID 83619-2202 |
| William J Dittrich | Pulmonary Disease | St Lukes Clinic-treasure Valley LLC | 1210 Nw 16th St, Fruitland, ID 83619-2202 |
| Patrick D Weis | Pulmonary Disease | St Lukes Clinic-treasure Valley LLC | 1210 Nw 16th St, Fruitland, ID 83619-2202 |
| David E Fonseca | Pulmonary Disease | St Lukes Clinic-treasure Valley LLC | 1210 Nw 16th St, Fruitland, ID 83619-2202 |
| Sogol Nowbar | Pulmonary Disease | St Lukes Clinic-treasure Valley LLC | 1210 Nw 16th St, Fruitland, ID 83619-2202 |
| Michael S Morris | Urology | St Lukes Clinic-treasure Valley LLC | 1210 Nw 16th St, Fruitland, ID 83619-2202 |
| Davis T Katseanes | Obstetrics/gynecology | St Lukes Clinic-treasure Valley LLC | 1210 Nw 16th St, Fruitland, ID 83619-2202 |
| Bret J Rodgers | Otolaryngology | 1210 Nw 16th St, Fruitland, ID 83619-2202 | |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jock C Perkins | Physician Assistant | Snake River Dermatology, Pa | 2101 N Whitley Dr, Fruitland, ID 83619-2132 |
| David J Owens | Chiropractic | 2007 N Whitley Dr, Fruitland, ID 83619-2132 | |
| Brock Arben Andersen | Dermatology | Snake River Dermatology, Pa | 2101 N Whitley Dr, Fruitland, ID 83619-2132 |
| Amanda K Crisler | Physician Assistant | Lifeways, Inc | 1611 N Whitley Dr, Suite 7, Fruitland, ID 83619-2180 |
| Candice L Louise | Clinical Social Worker | Lifeways, Inc | 1611 N Whitley Dr, Suite 7, Fruitland, ID 83619-2180 |
| Todd A Salzsieder | Physician Assistant | Lifeways, Inc | 1611 N Whitley Dr, Suite 7, Fruitland, ID 83619-2180 |
| Sarah A Andrade | Clinical Social Worker | Lifeways, Inc | 1611 N Whitley Dr, Fruitland, ID 83619-2180 |
| Si R Steinberg | Psychiatry | Lifeways, Inc | 1611 N Whitley Dr, Suite 7, Fruitland, ID 83619-2180 |
| Michael A Duncan | Chiropractic | 1710 N Whitley Dr, Suite C, Fruitland, ID 83619-2183 | |
| Matthew L Divietro | Pulmonary Disease | St Lukes Clinic-treasure Valley LLC | 1210 Nw 16th St, Fruitland, ID 83619-2202 |
| Find all physicians in zip 83619 | |||
| City | FRUITLAND |
| Zip Code | 83619 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | FRUITLAND + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Shannon R Vaughn.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.