SHANNON PERNELL (NPI# 1043681471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043681471 |
| Entity Type | Individual |
| Full Name | SHANNON PERNELL |
| Credential | R.N. |
| Practice Address |
513 Madison Ave Covington KY 41011-1562 |
| Mailing Address |
502 Farrell Dr Covington KY 41011-3717 |
| Practice Telephone | 8594313052 |
| Mailing Telephone | 8595783204 |
| Mailing Fax Number | 8595783273 |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2015-10-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
1116481 | KY | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | TAX ID | 610661458 | 01 |
| Street Address |
513 MADISON AVE |
| City | COVINGTON |
| State | KY |
| Zip Code | 41011-1562 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518921386 | Suzanne K. Barger | Registered Nurse | 513 Madison Ave, Covington, KY 41011-1562 | 2006-04-17 |
| 1144839457 | George Andrew Darling | Nurse Practitioner | 513 Madison Ave, Covington, KY 41011-1505 | 2020-07-23 |
| 1316576697 | Laurie Lewis | Nurse Practitioner | 513 Madison Ave, Covington, KY 41011-1505 | 2020-04-07 |
| 1356832497 | Courtney Gardner | Social Worker | 513 Madison Ave, Covington, KY 41011-1505 | 2018-05-24 |
| 1124536727 | Kristen Marie Bjerke | Counselor | 513 Madison Ave, Covington, KY 41011 | 2018-01-17 |
| 1922535525 | Joy Johnson | Counselor | 513 Madison Ave, Covington, KY 41011-1562 | 2017-05-15 |
| 1598291734 | Melanie Hug | Registered Nurse | 513 Madison Ave, Covington, KY 41011-1562 | 2017-05-09 |
| 1013443613 | Christina Simonds | Registered Nurse | 513 Madison Ave, Covington, KY 41011-1562 | 2017-05-03 |
| 1740739168 | Chelsey Derifield | Social Worker | 513 Madison Ave, Covington, KY 41011-1505 | 2016-09-27 |
| 1740738079 | Sierra Reeves | Social Worker | 513 Madison Ave, Covington, KY 41011-1562 | 2016-09-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053850925 | Gina Shields New | Physical Therapist | 1500 James Simpson Jr Drive, Covington, KY 41011 | 2017-02-13 |
| 1730623091 | Sarah S. Laube | Dietitian, Registered | 1500 James Simpson Jr. Way, Ste 301, St. Elizabeth Physicians Regional Diabetes Center, Covington, KY 41011 | 2016-12-06 |
| 1366858557 | Shannon Rebecca Russell | Social Worker | 434 Scott Blvd, Life Point Solutions, Covington, KY 41011 | 2014-07-08 |
| 1629417183 | Mortenson Family Dental Center- Ft Wright Pllc | Dentist | 1983 Dixie Hwy, Ft Mitchell, KY 41011 | 2013-06-18 |
| 1609150325 | Amanda Banks Galer | Social Worker | 1717 Dixie Hwy Ste 409, Ft Wright, KY 41011 | 2011-09-29 |
| 1750510004 | Marilyn Ruth Baker | Speech-Language Pathologist | 425 Garrad Street, Covington, KY 41011 | 2009-07-08 |
| 1093952327 | Douglas H Rank Md Psc | Psychiatry & Neurology | 12 West Pike St, Covington, KY 41011 | 2009-01-08 |
| 1376796722 | Bernice Raeann Calhoun | Counselor | 1955 Dixie Hwy Ste D, Ft Wright, KY 41011 | 2008-10-29 |
| 1609052265 | Marilyn Woods | Social Worker | 722 Scott Street, 3rd Floor, Covington, KY 41011 | 2008-01-14 |
| 1801089933 | Craig Louis Walsh | Dentist | 1846 Beacon Hill Ave, Fort Wright, KY 41011 | 2007-08-22 |
| Find all providers in zip 41011 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730792870 | Davidra Kaba | Registered Nurse | 1612 Versailles Business Pkwy Apt 1305, Covington, LA 70433-6191 | 2020-08-28 |
| 1083135057 | Joan Marie Ibos | Registered Nurse | 20153 Palm Blvd, Covington, LA 70435-6453 | 2017-06-29 |
| 1518921386 | Suzanne K. Barger | Registered Nurse | 513 Madison Ave, Covington, KY 41011-1562 | 2006-04-17 |
| 1588005581 | Desiree Zerhusen | Registered Nurse | 1401 Madison Ave, Covington, KY 41011-3313 | 2013-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033731419 | Kristen Rae Fugate | Registered Nurse | 101 Airport Gardens Rd Ste 200, Hazard, KY 41701-9510 | 2020-05-08 |
| 1457723033 | Lauren Bradbury | Registered Nurse | 1201 N. Ft. Thomas Ave., Ft. Thomas, KY 41075 | 2015-10-22 |
| 1033509393 | Dawn Garrett -wright | Registered Nurse | 350 Park Street Ste 204, Psychiatric Associates, Bowling Green, KY 42101-3516 | 2015-01-26 |
| 1548516040 | Danielle M. Mcpeak | Registered Nurse | 2355 Poplar Level Rd Ste 200, Louisville, KY 40217-1385 | 2012-08-02 |
| 1780816736 | Leigh Baldwin | Registered Nurse | 224 Powell St, Henderson, KY 42420-3529 | 2009-08-10 |
| 1962645853 | Freedom Psychiatry, Pllc | Registered Nurse | 489 Hammer Mill Rd, Wurtland, KY 41144-7798 | 2009-04-08 |
| 1053445858 | Gertrude Harmon | Registered Nurse | 869 Sparta Court, Lexington, KY 40504 | 2007-03-15 |
| 1558401497 | Roger L Moore | Registered Nurse | 710 Perryville Road, Harrodsburg, KY 40330 | 2007-02-08 |
| 1750316501 | Mindy Chandler | Registered Nurse | 1035 Porter Pike, Bowling Green, KY 42103-9581 | 2006-07-11 |
| 1780295402 | Anita Lynn Wells | Registered Nurse | 784 Highway 36, Frenchburg, KY 40322-8123 | 2020-08-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.