Shannon T Evellis (NPI# 1174810808, PAC ID# 4688843428) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1174810808 |
| PAC ID by PECOS | 4688843428 |
| Professional Enrollment ID | I20110811000400 |
| Full Name | Shannon T Evellis |
| Organization Legal Name | HUDSON HEADWATERS HEALTH NETWORK |
| Address |
100 Broad St Glens Falls NY 12801-4349 |
| Phone Number | 5187922223 |
| Gender | F |
| Medical School | ALBANY MEDICAL COLLEGE OF UNION UNIVERSITY |
| Graduation Year | 2011 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 7416861208 |
| Number of Group Practice Members | 137 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330191 | GLENS FALLS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 6223 State Route 9, Chestertown, NY 12817-2823 | 5184942761 | HUDSON HEADWATERS HEALTH NETWORK |
| 100 Broad St, Glens Falls, NY 12801-4349 | 5187922223 | HUDSON HEADWATERS HEALTH NETWORK |
| 161 Carey Rd, Queensbury, NY 12804-7821 | 5188248610 | HUDSON HEADWATERS HEALTH NETWORK |
| 24 Fairfield Ave, Schroon Lake, NY 12870-0292 | 5185327120 | HUDSON HEADWATERS HEALTH NETWORK |
| 3761 Main St, Warrensburg, NY 12885-1837 | 5186233918 | HUDSON HEADWATERS HEALTH NETWORK |
| 3767 Main St, Warrensburg, NY 12885-1837 | 5186232844 | HUDSON HEADWATERS HEALTH NETWORK |
| Organization Legal Name | HUDSON HEADWATERS HEALTH NETWORK |
| Physicians | 152 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Aaron Esterson | Family Medicine | Hudson Headwaters Health Network | 828 State Route 11, Champlain, NY 12919-4966 |
| Ashley Claire Eleanor Bernotas | Family Medicine | Hudson Headwaters Health Network | 87 Plaza Blvd, Plattsburgh, NY 12901-6438 |
| Cassie Elaine Leonard | Obstetrics/gynecology | Hudson Headwaters Health Network | 90 S St, Glens Falls, NY 12801-4353 |
| Sarah M Thompson | Family Medicine | Hudson Headwaters Health Network | 6223 State Route 9, Chestertown, NY 12817-2823 |
| Kristine Blais Alix | Nurse Practitioner | Hudson Headwaters Health Network | 11 Cross St, Bolton Landing, NY 12814-7711 |
| Rita L All | Nurse Practitioner | Hudson Headwaters Health Network | 100 Broad St, Glens Falls, NY 12801-4349 |
| Maurice A Racine | Family Medicine | Hudson Headwaters Health Network | 24 Fairfield Ave, Schroon Lake, NY 12870-0292 |
| Christopher H Jackson | Physician Assistant | Hudson Headwaters Health Network | 126 Ski Bowl Rd, North Creek, NY 12853-2607 |
| Howard E Silverberg | Internal Medicine | Hudson Headwaters Health Network | 48 E St, Fort Edward, NY 12828-1811 |
| Harriet Busch | Family Practice | Hudson Headwaters Health Network | 14 Manor Dr, Queensbury, NY 12804-1906 |
| Street Address |
100 BROAD ST |
| City | GLENS FALLS |
| State | NY |
| Zip | 12801-4349 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rita L All | Nurse Practitioner | Hudson Headwaters Health Network | 100 Broad St, Glens Falls, NY 12801-4349 |
| Amanda L Clements | Physician Assistant | Hudson Headwaters Health Network | 100 Broad St, Glens Falls, NY 12801-4349 |
| Scott C Miller | Physician Assistant | Hudson Headwaters Health Network | 100 Broad St, Glens Falls, NY 12801-4349 |
| Taylor Dempsey | Physician Assistant | Hudson Headwaters Health Network | 100 Broad St, Glens Falls, NY 12801-4349 |
| Sean P Campanie | Nurse Practitioner | Hudson Headwaters Health Network | 100 Broad St, Glens Falls, NY 12801-4349 |
| Magdeline Inzerilli | Physician Assistant | Hudson Headwaters Health Network | 100 Broad St, Glens Falls, NY 12801-4349 |
| Abigail R Charter | Physician Assistant | Hudson Headwaters Health Network | 100 Broad St, Glens Falls, NY 12801-4349 |
| Robert H Beaty | Family Medicine | Hudson Headwaters Health Network | 100 Broad St, Glens Falls, NY 12801-4349 |
| James C Hicks | Family Medicine | Hudson Headwaters Health Network | 100 Broad St, Glens Falls, NY 12801-4349 |
| Denise N Richard | Nurse Practitioner | Hudson Headwaters Health Network | 100 Broad St, Glens Falls, NY 12801-4349 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cara A Bedore | Qualified Audiologist | Susan Boggia Audiology, PC | 318 Ridge St, Glens Falls, NY 12801-1552 |
| Susan C Boggia | Qualified Audiologist | Susan Boggia Audiology, PC | 318 Ridge St, Glens Falls, NY 12801-1552 |
| Debra J Pietrangelo | Psychologist, Clinical | 499 Glen St, Glens Falls, NY 12801-2205 | |
| Lynn M Edgerly | Clinical Social Worker | 499 Glen St, Glens Falls, NY 12801-2205 | |
| Brenda J Arley | Certified Clinical Nurse Specialist (cns) | 499 Glen St, Glens Falls, NY 12801-2205 | |
| Joseph Mckay | Clinical Social Worker | 498 Glen St, Glens Falls, NY 12801-2230 | |
| Peter M Hughes | Urology | 526 Glen St, Glens Falls, NY 12801-2232 | |
| Terry L Walton | Optometry | Terry L Walton Doctor of Optometry PC | 575 Glen St, Box 2071, Glens Falls, NY 12801-2243 |
| Brenda M Dobie | Optometry | Adirondack Eye Physicians and Surgeons PC | 152 Bay St, Glens Falls, NY 12801-2329 |
| Richard S Price | Optometry | Adirondack Eye Physicians and Surgeons PC | 152 Bay St, Glens Falls, NY 12801-2329 |
| Find all physicians in zip 12801 | |||
| City | GLENS FALLS |
| Zip Code | 12801 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | GLENS FALLS + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Shannon T Evellis.
| 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.