Shannon L Peck (NPI# 1346531928, PAC ID# 3678751633) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1346531928 |
| PAC ID by PECOS | 3678751633 |
| Professional Enrollment ID | I20141205000716 |
| Full Name | Shannon L Peck |
| Organization Legal Name | KEITH MARK GROSS MD INC |
| Address |
51 E Haskell Rd B Winnemucca NV 89445-3523 |
| Phone Number | 7756239346 |
| Gender | F |
| Graduation Year | 2010 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4587712500 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 290008 | NORTHEASTERN NEVADA REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1900 Idaho St, Suite 102, Elko, NV 89801-2637 | 7757539799 | KEITH MARK GROSS MD INC |
| 51 E Haskell Rd B, Winnemucca, NV 89445-3523 | 7756239346 | KEITH MARK GROSS MD INC |
| Organization Legal Name | KEITH MARK GROSS MD INC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Teresa C Langslet | Physician Assistant | Keith Mark Gross Md Inc | 12550 Hesperia Rd, Suite 218, Victorville, CA 92395-5873 |
| Keith M Gross | Dermatology | Keith Mark Gross Md Inc | 1113 Alta Ave, Suite 200, Upland, CA 91786-2803 |
| Street Address |
51 E HASKELL RD B |
| City | WINNEMUCCA |
| State | NV |
| Zip | 89445-3523 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cody Sam Bengoa | Optometry | Bengoa Eye Care Ltd | 1050 Hanson St, Winnemucca, NV 89445-2774 |
| Thomas David Gall | Optometry | Bengoa Eye Care Ltd | 1050 Hanson St, Winnemucca, NV 89445-2774 |
| Dennis P Verner | Chiropractic | 504 E 2nd St, Winnemucca, NV 89445-2827 | |
| Lawrence P Shank | Orthopedic Surgery | Synergy Surgicalists Inc | 118 E Haskell St B, Winnemucca, NV 89445-3247 |
| Ajeet Mahendernath | Family Medicine | Winnemucca Emergency Physicians LLC | 118 E Haskell St, Winnemucca, NV 89445-3247 |
| Richard V Davis | Orthopedic Surgery | Synergy Surgicalists Inc | 118 E Haskell St B, Winnemucca, NV 89445-3247 |
| Katharina C Mahadeva | Internal Medicine | 118 E Haskell St, Winnemucca, NV 89445-3247 | |
| George H Taylor | Emergency Medicine | Winnemucca Emergency Physicians LLC | 118 E Haskell St, Winnemucca, NV 89445-3247 |
| James M Langevin | General Surgery | 118 E Haskell St, Winnemucca, NV 89445-3247 | |
| Andrew B Emmerman | Internal Medicine | Humboldt General Hospital | 118 E Haskell St, Winnemucca, NV 89445-3247 |
| Find all physicians in zip 89445 | |||
| City | WINNEMUCCA |
| Zip Code | 89445 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | WINNEMUCCA + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Shannon L Peck.
| 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.