SHANNON BRYANT HORNSBY (NPI# 1164961678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164961678 |
| Entity Type | Individual |
| Full Name | SHANNON BRYANT HORNSBY |
| Credential | AG-APRN |
| Practice Address |
1150 N 35th Ave Ste 440 Hollywood FL 33021-5430 |
| Mailing Address |
2900 Corporate Way Door D Miramar FL 33025-3925 |
| Practice Telephone | 9542656356 |
| Practice Fax Number | 9549855154 |
| Mailing Telephone | 9542765685 |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2020-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
ARNP9352328 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 020121200 | 05 |
| Street Address |
1150 N 35TH AVE STE 440 |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021-5430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871573097 | Brian Bruckner | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1150 N 35th Ave Ste 440, Hollywood, FL 33021-5430 | 2006-01-23 |
| 1467879379 | Jeremy J. Song | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1150 N 35th Ave Ste 440, Hollywood, FL 33021-5430 | 2014-03-28 |
| 1538497086 | South Broward Hospital District | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1150 N 35th Ave Ste 440, Hollywood, FL 33021 | 2009-11-20 |
| 1609001213 | Gaston Gregoire | Nurse Practitioner | 1150 N 35th Ave Ste 440, Hollywood, FL 33021 | 2009-05-27 |
| 1023020310 | Louis Carlisle | Physician Assistant | 1150 N 35th Ave Ste 440, Hollywood, FL 33021-5430 | 2006-08-13 |
| 1356378533 | I-wen Wang | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1150 N 35th Ave Ste 440, Hollywood, FL 33021 | 2006-06-26 |
| 1255385480 | Richard Perryman | Pediatrics | 1150 N 35th Ave Ste 440, Hollywood, FL 33021 | 2006-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548893894 | Seminole Tribe of Florida Health Department | Pharmacy | 111 W. Coral Way, Hollywood, FL 33021 | 2020-02-14 |
| 1437714086 | Emilia Roxana Gucciardo | Physician Assistant | 4510 Sheridan Street, Attn: William Pepe, Hollywood, FL 33021 | 2019-05-08 |
| 1649763673 | Sabrina Shoba Mathura | Behavior Technician | 4400 Madison St, Hollywood, FL 33021 | 2018-06-13 |
| 1558850149 | South Broward Hospital District | Pediatrics | 105 Joe Dimaggio Dr, Pediatric Heart Station, Hollywood, FL 33021 | 2018-05-09 |
| 1942798368 | Kyndra Monique Liburd | Student in an Organized Health Care Education/Training Program | Attn: Pediatric Residency Program, 1005 Joe Dimaggio Drive, Hollywood, FL 33021 | 2018-05-01 |
| 1992292106 | Madeleine Mariela Reyes | Nurse Practitioner | 5010 Hollywood Boulevard #100-b, Hollywood, FL 33021 | 2018-04-13 |
| 1487168233 | Gynecologic Oncology & Urogynecology | Obstetrics & Gynecology | 1150 N 35th Ave Ste 670, Hollywood, FL 33021 | 2017-11-30 |
| 1245743012 | Healix Healthcare Services, LLC | Obstetrics & Gynecology | 3990 Sheridan St Ste 207, Hollywood, FL 33021 | 2017-11-14 |
| 1093233587 | Benjamin Laborde | Physical Therapy Assistant | 4200 Washington Street, Hollywood, FL 33021 | 2017-09-05 |
| 1477079358 | Tt Trans, LLC | Non-emergency Medical Transport (VAN) | 3550 Washington Street, 502, Hollywood, FL 33021 | 2017-08-22 |
| Find all providers in zip 33021 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598396269 | Hattie Runzheimer | Nurse Practitioner | 847 Tyler St, Hollywood, FL 33019-1326 | 2020-01-30 |
| 1013458561 | Wendy Phreud Edmond | Nurse Practitioner | 1151 S Park Rd Apt 110, Hollywood, FL 33021-8793 | 2017-03-16 |
| 1073901179 | Andree Carpentier | Nurse Practitioner | 2100 Van Buren St, 522, Hollywood, FL 33020-7340 | 2014-12-26 |
| 1932728714 | Patricia L. Altamirano | Nurse Practitioner | 3501 Johnson St, Hollywood, FL 33021-5421 | 2020-04-13 |
| 1699308809 | Lakota Campos | Nurse Practitioner | 3501 Johnson St, Hollywood, FL 33021-5421 | 2020-02-16 |
| 1033773890 | Amanda J Dolif | Nurse Practitioner | 11011 Sheridan St Ste 109, Hollywood, FL 33026-1501 | 2019-04-26 |
| 1982074860 | Brittany Amato | Nurse Practitioner | 3501 Johnson St, 3rd Floor, Hollywood, FL 33021-5421 | 2015-10-05 |
| 1770825317 | Rosario Epe Dominguez | Nurse Practitioner | 1150 N 35th Ave, Suite 605, Hollywood, FL 33021-5424 | 2013-03-21 |
| 1790095073 | Latoya Nicole Lattibeaudiere | Nurse Practitioner | 3501 Johnson St, Floor 3, Hollywood, FL 33021-5421 | 2010-10-20 |
| 1801109335 | Juan Luis Segura | Nurse Practitioner | 3501 Johnson St, Hollywood, FL 33021-5421 | 2010-07-26 |
| Find all providers in HOLLYWOOD | ||||
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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.