DR. SHANNON KOHAKE (NPI# 1063631380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063631380 |
| Entity Type | Individual |
| Full Name | DR. SHANNON KOHAKE |
| Other Name | SHANNON DALE |
| Credential | MD |
| Practice Address |
2790 Clay Edwards Dr Ste 1235 North Kansas City MO 64116-3276 |
| Practice Telephone | 8164725157 |
| Practice Fax Number | 8164727200 |
| Mailing Telephone | 8164725157 |
| Mailing Fax Number | 8164727200 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-11-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
2010028604 | MO | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
35.093769 | OH | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
43050 | KY | Allopathic & Osteopathic Physicians |
| Street Address |
2790 CLAY EDWARDS DR STE 1235 |
| City | NORTH KANSAS CITY |
| State | MO |
| Zip Code | 64116-3276 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205326212 | Sara J Miller | Nurse Practitioner | 2790 Clay Edwards Dr Ste 1235, North Kansas City, MO 64116 | 2018-05-15 |
| 1942596523 | John David Eatman | Psychiatry & Neurology | 2790 Clay Edwards Dr Ste 1235, North Kansas City, MO 64116-3276 | 2011-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326503830 | Ladeja Holland | Student in an Organized Health Care Education/Training Program | 4421 N Oak Trfy, Kansas City, MO 64116 | 2019-02-08 |
| 1982179388 | Casady's Counseling | Counselor | 1201 Nw Briarcliff Pkwy Ste 200 Office233, Kansas City, MO 64116 | 2018-10-11 |
| 1427543818 | Amanda E Foster | Physical Therapist | 3810 N Mulberry Drive 202, Kansas City, MO 64116 | 2018-06-27 |
| 1992290555 | Lucas J Mathes | Physician Assistant | 2790 Clay Edwards Drive, Suite 650, North Kansas City, MO 64116 | 2018-06-26 |
| 1952828816 | Danielle Marie Rush | Physical Therapist | 1501 Nw 38th St., Apt. 305, Kansas City, MO 64116 | 2017-08-23 |
| 1992229629 | Ankita Bhakta | Physical Therapy Assistant | 4407 N Mulberry Dr, Kansas City, MO 64116 | 2017-08-03 |
| 1720430945 | Deon Hicks | Physical Therapist | 851 Nw 45th Street, Suite 209, Kansas City, MO 64116 | 2016-07-12 |
| 1851712228 | Cindy Eldridge | Counselor | 1201 Nw Briarcliff Pkwy Ste 200, Kansas City, MO 64116 | 2014-01-02 |
| 1841629904 | Jamie Lyn Jackson | Specialist/Technologist | 2790 Clay Edwards Dr. Ste #650, North Kansas City, MO 64116 | 2013-11-08 |
| 1487099388 | Lisa M Grasing | Family Medicine | 4150 N. Mulberry Dr, Suite 160, Kansas City, MO 64116 | 2013-05-06 |
| Find all providers in zip 64116 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023439833 | Meritas Health Corporation | Psychiatry & Neurology | 2790 Clay Edwards Dr, Suite 1235, North Kansas City, MO 64116-3276 | 2013-12-20 |
| 1942596523 | John David Eatman | Psychiatry & Neurology | 2790 Clay Edwards Dr Ste 1235, North Kansas City, MO 64116-3276 | 2011-06-22 |
| 1679884704 | Scott Michael Shorten | Psychiatry & Neurology | 2790 Clay Edwards Dr, Suite 1235, North Kansas City, MO 64116-3276 | 2010-06-23 |
| 1700895083 | Steven C Kosa | Psychiatry & Neurology | 2790 Clay Edwards Dr, Suite 1235, North Kansas City, MO 64116-3276 | 2006-08-05 |
| 1972540524 | Northland Neurological Associates, P.C. | Psychiatry & Neurology | 2790 Clay Edwards Dr, Suite 500, North Kansas City, MO 64116-3276 | 2006-06-01 |
| 1033163266 | Jeffrey W Thornton | Psychiatry & Neurology | 2790 Clay Edwards Dr, Suite 1235, North Kansas City, MO 64116-3276 | 2006-05-20 |
| 1104881069 | Robert Louis Satake | Psychiatry & Neurology | 2790 Clay Edwards Dr, Suite 500, North Kansas City, MO 64116-3276 | 2006-04-20 |
| 1700849213 | Cynthia J Ward | Psychiatry & Neurology | 2790 Clay Edwards Dr, Suite 1235, North Kansas City, MO 64116-3276 | 2006-04-07 |
| 1386606572 | Fred L Sachen | Psychiatry & Neurology | 2790 Clay Edwards Dr, Suite 500, North Kansas City, MO 64116-3276 | 2006-04-04 |
| 1801857891 | Larry C Hollenbeck | Psychiatry & Neurology | 2790 Clay Edwards Dr, Suite 1235, North Kansas City, MO 64116-3276 | 2006-03-29 |
| Find all providers in NORTH KANSAS CITY | ||||
| City | NORTH KANSAS CITY |
| Zip Code | 64116 |
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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.