SHANNON CHURCH (NPI# 1104364686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104364686 |
| Entity Type | Individual |
| Full Name | SHANNON CHURCH |
| Practice Address |
5 Palisades Drive Suite 200 St. Peter's Internal Medicine Albany NY 12205-6433 |
| Mailing Address |
Po Box 14890 St. Peter's Health Partners Payer Credentialing Albany NY 12212-4890 |
| Practice Telephone | 5184380019 |
| Practice Fax Number | 5184380299 |
| Mailing Telephone | 5185255634 |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-02-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 611605 | NY | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
F341370-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255619870 | Shannon Church | Doula | 406 Platt St, Rapid City, SD 57702-2310 | 2011-07-31 |
| 1164767778 | Shannon Ann Church | Social Worker | 1340 Broad Ave, Ste 410, Gulfport, MS 39501-2404 | 2012-12-07 |
| 1164750105 | Shannon L. Church | Physician Assistant | 271 Carew St, Springfield, MA 01104-2377 | 2009-12-03 |
| Street Address |
5 PALISADES DRIVE SUITE 200 ST. PETER'S INTERNAL MEDICINE |
| City | ALBANY |
| State | NY |
| Zip Code | 12205-6433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912908195 | John M. Bashant | Internal Medicine | 5 Palisades Drive Suite 200, St. Peter's Internal Medicine, Albany, NY 12205-6433 | 2005-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518564053 | Capital Regional Rx LLC | Pharmacy | 431 New Karner Road Bldg#4 Suite 180, Albany, NY 12205 | 2020-10-07 |
| 1548722549 | The Alternative Living Group, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 500 New Karner Road, Suite 3, Albany, NY 12205 | 2019-04-01 |
| 1003398439 | Sarah Itwaru | Social Worker | 401 New Karner Road, Albany, NY 12205 | 2018-09-01 |
| 1740708106 | Kenneth Cook | Physician Assistant | 121everett Rd, Albany, NY 12205 | 2017-09-06 |
| 1437691839 | Sarah Avery | Physical Therapist | 5 S Family Dr, Colonie, NY 12205 | 2016-11-16 |
| 1063892776 | Olsen Medical Sales, LLC | Durable Medical Equipment & Medical Supplies | 98 Everett Rd, Albany, NY 12205 | 2015-06-08 |
| 1972921484 | Alixandra Joy Foisy | Social Worker | 42 Oakwood Dr, Albany, NY 12205 | 2014-04-01 |
| 1780015206 | The Promptcare Companies | Durable Medical Equipment & Medical Supplies | 1015c Central Avenue, Albany, NY 12205 | 2013-12-09 |
| 1396088332 | Early Childhood Education Center | Day Training, Developmentally Disabled Services | 251 Washington Ave Extension, Albany, NY 12205 | 2013-03-28 |
| 1487906707 | Centerfordisabiltyservices | Preferred Provider Organization | 5 Keller Street, Albany, NY 12205 | 2012-10-10 |
| Find all providers in zip 12205 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275131583 | Mfon Bassey | Nurse Practitioner | 14 N Manning Blvd Apt B-25, Albany, NY 12206-1963 | 2020-10-09 |
| 1245837194 | Thomas W Mansfield | Nurse Practitioner | 425 W 3rd Ave Ste 410, Albany, GA 31701-1954 | 2020-10-05 |
| 1770199408 | April Mccluster | Nurse Practitioner | 2753 Bettys Dr, Albany, GA 31705-9510 | 2020-09-17 |
| 1457967317 | Cynthia Ann Chaney | Nurse Practitioner | 4546 Lacosta Dr, Albany, GA 31721-9433 | 2020-09-16 |
| 1083223135 | Jamila Cruz | Nurse Practitioner | 1758 Philema Rd S, Albany, GA 31701-4781 | 2020-07-24 |
| 1083239313 | Danajoy Melissa Vincent | Nurse Practitioner | 416 Partridge Dr, Albany, GA 31707-3038 | 2020-06-12 |
| 1033744602 | Rodesia Ashanta Woodson | Nurse Practitioner | 2504 Devon Dr, Albany, GA 31721-2128 | 2020-03-04 |
| 1972156057 | Kristen Lynn Cook | Nurse Practitioner | 2601 Stuart Ave Ste 100, Albany, GA 31707-1664 | 2019-07-18 |
| 1255992046 | Jennifer Lieberman | Nurse Practitioner | 1365 Washington Ave Ste 100, Albany, NY 12206-1098 | 2019-06-24 |
| 1053976993 | Amanda Bylsma | Nurse Practitioner | 5 Palisades Dr Ste 200, Albany, NY 12205-6433 | 2019-05-07 |
| Find all providers in ALBANY | ||||
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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.