Shannon R Vaughn
ST LUKES CLINIC-TREASURE VALLEY LLC


Address: 1210 Nw 16th St, Fruitland, ID 83619-2202
Phone: 2084528600

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.

Physician Overview

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

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
130006 ST LUKE'S REGIONAL MEDICAL CENTER
130071 ST LUKE'S NAMPA MEDICAL CENTER

Other Locations

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 Information

Organization Legal Name ST LUKES CLINIC-TREASURE VALLEY LLC
Physicians 831

Physicians with the same organization

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

Office Location

Street Address 1210 NW 16TH ST
City FRUITLAND
State ID
Zip 83619-2202

Physicians in the same location

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
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Physicians in the same zip code

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

Competitor

Search similar physicians

City FRUITLAND
Zip Code 83619
Specialty NURSE PRACTITIONER
City + Specialty FRUITLAND + NURSE PRACTITIONER

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Dataset Information

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.

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