SHELLY WIMMER (NPI# 1083092514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083092514 |
| Entity Type | Individual |
| Full Name | SHELLY WIMMER |
| Credential | PA-C |
| Practice Address |
1430 Monmouth St Independence OR 97351-1127 |
| Practice Telephone | 5038381133 |
| Practice Fax Number | 5038385138 |
| Mailing Telephone | 5038381133 |
| Mailing Fax Number | 5038385138 |
| Enumeration Date | 2015-05-17 |
| Last Update Date | 2017-03-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA 1779965 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | NPI | 1083092514 | 01 |
| Street Address |
1430 MONMOUTH ST |
| City | INDEPENDENCE |
| State | OR |
| Zip Code | 97351-1127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598868515 | Independence-monmouth Family Medicine PC | Family Medicine | 1430 Monmouth St, Independence, OR 97351 | 2006-09-06 |
| 1538535059 | Wvp Medical Group, LLC | Clinic/Center | 1430 Monmouth St, Independence, OR 97351-1127 | 2015-08-19 |
| 1972990174 | Terrell Glenn | Family Medicine | 1430 Monmouth St, Independence, OR 97351-1127 | 2015-04-25 |
| 1265727515 | Mary Susanne Placek | Family Medicine | 1430 Monmouth St, Independence, OR 97351-1127 | 2011-06-15 |
| 1659490092 | Janice Hoida | Physician Assistant | 1430 Monmouth St, Independence, OR 97351-1127 | 2007-03-28 |
| 1407959422 | Keith Allen White | Family Medicine | 1430 Monmouth St, Independence, OR 97351 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821070111 | Kenneth R Winokur | Dentist | 329 South Main St, Independence, OR 97351 | 2005-11-14 |
| 1710044144 | Kenneth R Winokur Dmd PC | Dentist | 329 S Main St, Independence, OR 97351 | 2007-01-03 |
| 1609901024 | Evan L Evans | Audiologist | 1343 A Monmouth St, Independence, OR 97351-0248 | 2007-02-23 |
| 1497703201 | Evergreen Oregon Healthcare Independence, L.L.C. | Skilled Nursing Facility | 1525 Monmouth St, Independence, OR 97351-1007 | 2006-05-04 |
| 1518127844 | David Patrick Mcdarby | Physical Therapist | 1525 Monmouth St, Independence, OR 97351-1007 | 2008-06-10 |
| 1881854115 | Bobbi Jo Shrum | Physical Therapy Assistant | 1525 Monmouth St, Independence, OR 97351-1007 | 2008-06-10 |
| 1639426208 | Central School District 13j | Local Education Agency (LEA) | 1610 Monmouth St, Independence, OR 97351-1008 | 2012-08-13 |
| 1851645931 | Holli Watkin | Nurse Practitioner | 1601 Monmouth St Ste 100, Independence, OR 97351-1019 | 2012-10-29 |
| 1699394585 | Jennifer Elizabeth O'sullivan | Specialist/Technologist | 1369 Monmouth St, Independence, OR 97351-1126 | 2020-04-10 |
| 1336108711 | Independence Pharmacy, Inc | Pharmacy | 1357 Monmouth St, Independence, OR 97351-1126 | 2006-03-22 |
| Find all providers in zip 97351 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912538752 | Karen Anghel | Physician Assistant | 804 S Kisner Dr, Independence, MO 64056-3062 | 2020-01-30 |
| 1295259588 | Lindsey Grant | Physician Assistant | 19550 E 39th St S Ste 410, Independence, MO 64057-2307 | 2017-07-28 |
| 1013451558 | Courtney Adams | Physician Assistant | 19550 E 39th St S, Ste 410, Independence, MO 64057-2358 | 2016-12-16 |
| 1649725714 | Lacey Elizabeth Perez | Physician Assistant | 19600 E 39th St S, Independence, MO 64057-2301 | 2016-08-18 |
| 1033519830 | Mallory E. Harris | Physician Assistant | 3751 W Main St, Independence, KS 67301-8446 | 2014-08-28 |
| 1942569215 | Stephen Daniel Miller | Physician Assistant | 19550 E 39th St S, Ste 410, Independence, MO 64057-2303 | 2012-05-08 |
| 1912288960 | Susan Winterhalter Decker | Physician Assistant | 6801 Brecksville Rd Ste 10, Independence, OH 44131-5057 | 2011-09-05 |
| 1730415597 | Emily M Hennes | Physician Assistant | 19550 E 39th St S, Ste 410, Independence, MO 64057-2303 | 2009-10-28 |
| 1205075249 | Tangipahoa Emergency Group LLC | Physician Assistant | 52579 Highway 51 S, Independence, LA 70443-2231 | 2009-02-16 |
| 1902097751 | Marymount Primary Care Services, Inc. | Physician Assistant | 6701 Rockside Rd, Suite 260, Independence, OH 44131-2358 | 2007-08-07 |
| Find all providers in INDEPENDENCE | ||||
| City | INDEPENDENCE |
| Zip Code | 97351 |
Please comment or provide details below to improve the information on SHELLY WIMMER.
| 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.