Jerry K Gideon (NPI# 1629053384, PAC ID# 7315045846) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PATHOLOGY.
| Nation Provider ID (NPI) | 1629053384 |
| PAC ID by PECOS | 7315045846 |
| Professional Enrollment ID | I20070607000274 |
| Full Name | Jerry K Gideon |
| Organization Legal Name | SHANNON CLINIC |
| Address |
3150 Appaloosa Cir San Angelo TX 76901-5225 |
| Phone Number | 3252248309 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON |
| Graduation Year | 1988 |
| Primary Specialty | PATHOLOGY |
| Group Practice PAC ID | 0840103727 |
| Number of Group Practice Members | 279 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450571 | SHANNON MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 102 N Magdalen, San Angelo, TX 76903 | SHANNON CLINIC | |
| 120 E Beauregard, San Angelo, TX 76903 | 9156581511 | SHANNON CLINIC |
| 120 E Harris, San Angelo, TX 76903 | 9156581511 | SHANNON CLINIC |
| 215 E College, San Angelo, TX 76903 | 9154812294 | SHANNON CLINIC |
| 220 E Harris, San Angelo, TX 76903 | 3256581511 | SHANNON CLINIC |
| 2237 S Jackson St, San Angelo, TX 76903-9248 | 3256581511 | SHANNON CLINIC |
| 2239 N Bryant, San Angelo, TX 76903 | 9156587561 | SHANNON CLINIC |
| 225 E Beauregard, San Angelo, TX 76903 | 9156581511 | SHANNON CLINIC |
| 2450 N Bryant Blvd, San Angelo, TX 76903-2866 | 3256537916 | SHANNON CLINIC |
| 2626 N Bryant Blvd, San Angelo, TX 76903-2861 | 3254812271 | SHANNON CLINIC |
| 3150 Appaloosa Cir, San Angelo, TX 76901-5225 | 3252248309 | SHANNON CLINIC |
| 402 W 26th St, San Angelo, TX 76903-2826 | 3254812191 | SHANNON CLINIC |
| Organization Legal Name | SHANNON CLINIC |
| Physicians | 315 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kaushal Sondarwa | Nephrology | Shannon Clinic | 220 E Harris, San Angelo, TX 76903 |
| Mark Hinton | Psychiatry | Shannon Clinic | 2018 Pulliam St, San Angelo, TX 76905-5148 |
| Roxanne Timm | Nurse Practitioner | Shannon Clinic | 225 E Beauregard, San Angelo, TX 76903 |
| Kathie M Horrace Voigt | Family Medicine | Shannon Clinic | 4251 Sunset Dr, San Angelo, TX 76904-5653 |
| Maegin M Carlile | Nurse Practitioner | Shannon Clinic | 120 E Beauregard, San Angelo, TX 76903 |
| Natalie Marie Mcdonald | Physician Assistant | Shannon Clinic | 2626 N Bryant Blvd, San Angelo, TX 76903-2861 |
| Glen M Mcferren | Psychiatry | Shannon Clinic | 2020 Pulliam St, San Angelo, TX 76905-5148 |
| Brandi Lynn Whitehead | Physician Assistant | Shannon Clinic | 102 N Magdalen, San Angelo, TX 76903 |
| Buren A Whitten | Physician Assistant | Shannon Clinic | 104 N Ave H, Ozona, TX 76943-0907 |
| Edward L Grimes | Optometry | Shannon Clinic | 4450 Sunset Dr, San Angelo, TX 76904 |
| Street Address |
3150 APPALOOSA CIR |
| City | SAN ANGELO |
| State | TX |
| Zip | 76901-5225 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jonathan S Gipson | Anesthesiology | Shannon Clinic | 3150 Appaloosa Cir, San Angelo, TX 76901-5225 |
| Aniraphone Laochareun | Physician Assistant | Shannon Clinic | 3150 Appaloosa Cir, San Angelo, TX 76901-5225 |
| John C Neumann | Anesthesiology | Shannon Clinic | 3150 Appaloosa Cir, San Angelo, TX 76901-5225 |
| Dustin R Fentress | Physician Assistant | Shannon Clinic | 3150 Appaloosa Cir, San Angelo, TX 76901-5225 |
| Ross A Harper | Diagnostic Radiology | Shannon Clinic | 3150 Appaloosa Cir, San Angelo, TX 76901-5225 |
| Bonnie B Wickham | Physician Assistant | Shannon Clinic | 3150 Appaloosa Cir, San Angelo, TX 76901-5225 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lori Marie Simpson | Speech Language Pathologist | Reeves Rehab | 105 Westland St, San Angelo, TX 76901-3051 |
| Iris S Reeves | Speech Language Pathologist | Reeves Rehab | 105 Westland St, San Angelo, TX 76901-3051 |
| Alan C Larsen | Optometry | 2705 Sherwood Way, San Angelo, TX 76901-3091 | |
| Leslie L Bennett | Clinical Social Worker | 2002 Colorado Ave, San Angelo, TX 76901-3906 | |
| Charlotte L Lindsey | Nurse Practitioner | Concho Valley Center for Human Advancement | 1501 W Beauregard, San Angelo, TX 76901-4004 |
| Sherry D Crowder | Nurse Practitioner | Concho Valley Center for Human Advancement | 1501 W Beauregard, San Angelo, TX 76901-4004 |
| Heath B Foreman | Psychiatry | Concho Valley Center for Human Advancement | 1501 W Beauregard, San Angelo, TX 76901-4004 |
| John D Walsh | Nurse Practitioner | Concho Valley Center for Human Advancement | 1501 W Beauregard, San Angelo, TX 76901-4004 |
| John P Matthews | Optometry | 115 S Adams St, San Angelo, TX 76901-4101 | |
| Johnny K Burkhalter | Psychologist, Clinical | 1609 S Monroe St, San Angelo, TX 76901-4425 | |
| Find all physicians in zip 76901 | |||
| City | SAN ANGELO |
| Zip Code | 76901 |
| Specialty | PATHOLOGY |
| City + Specialty | SAN ANGELO + PATHOLOGY |
Please comment or provide details below to improve the information on Jerry K Gideon.
| 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.