JENNY LYNNE SHAFFER (NPI# 1073838322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073838322 |
| Entity Type | Individual |
| Full Name | JENNY LYNNE SHAFFER |
| Other Name | JENNY LYNNE BUCK |
| Credential | M.D. |
| Practice Address |
10010 Kennerly Road Attn Cancer Care Center St Louis MO 63128-2106 |
| Mailing Address |
11475 Olde Cabin Rd Ste 200 Saint Louis MO 63141-7129 |
| Practice Telephone | 3145251688 |
| Practice Fax Number | 3145251689 |
| Mailing Telephone | 3149918200 |
| Mailing Fax Number | 3149918206 |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2018-04-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
2017014159 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 1073838322 | 05 |
| Street Address |
10010 KENNERLY ROAD ATTN CANCER CARE CENTER |
| City | ST LOUIS |
| State | MO |
| Zip Code | 63128-2106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366431595 | Stephen E Godfrey | Pathology | 10010 Kennerly Road, St Louis, MO 63128 | 2005-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033227806 | Humberto M Fagundes | Radiology | 3015 N New Ballas Rd, St Louis, MO 63131 | 2006-08-29 |
| 1316967722 | Macdonald B Logie | Radiology | 3635 Vista, St Louis, MO 63110 | 2006-07-20 |
| 1063439677 | Bruce J Walz | Radiology | 3635 Vista, St Louis, MO 63110 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778228 | Central Care, Pa | Radiology | 1004 Carondelet Dr Ste 410, Kansas City, MO 64114-4801 | 2020-10-23 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1518229772 | Andrew L Walker | Radiology | 902 N Riverside Rd Ste 201, Saint Joseph, MO 64507 | 2012-06-13 |
| 1568721454 | Jason Matthew Edwards | Radiology | 232 S Woods Mill Rd Ste 110e, Chesterfield, MO 63017 | 2012-05-11 |
| 1649569385 | Sagar Chandravadan Patel | Radiology | 211 Saint Francis Dr Ste 372, Cape Girardeau, MO 63703-5049 | 2011-04-04 |
| 1922326958 | Yvonne Thanh-nga D Pham | Radiology | 6601 Winchester Ave Ste 230, Kansas City, MO 64133-4681 | 2010-05-14 |
| 1811158587 | Benjamin Bin Yan | Radiology | 1111 Kentucky Ave., Omc Cancer Treatment Center, West Plains, MO 65775-2028 | 2008-06-24 |
| 1336338912 | Joseph Fields | Radiology | 9 Heather Hill Ln, Saint Louis, MO 63132-4105 | 2007-10-18 |
| 1205033941 | Associates In Tumor Therapy, Chartered | Radiology | 2801 Clearwater Ct, Joplin, MO 64801-8239 | 2007-06-27 |
| 1700916848 | Bethesda Resources Inc | Radiology | 1124 N Main St, Sikeston, MO 63801-5046 | 2007-03-07 |
| Find all providers with the same taxonomy | ||||
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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.