DR. SHANNON ROBERTS (NPI# 1235306119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1235306119 |
Entity Type | Individual |
Full Name | DR. SHANNON ROBERTS |
Other Name | DR. SHANNON MODDEJONGE |
Credential | D.C. |
Practice Address |
3786 S East St Indianapolis IN 46227-1241 |
Practice Telephone | 3177911511 |
Practice Fax Number | 3177911534 |
Mailing Telephone | 3177911511 |
Mailing Fax Number | 3177911534 |
Enumeration Date | 2008-05-10 |
Last Update Date | 2011-07-29 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 111N00000X | Chiropractor | 3943 | OH | Chiropractic Providers |
Y | 111N00000X | Chiropractor | 08002519A | IN | Chiropractic Providers |
N | 111N00000X | Chiropractor | 10800 | TX | Chiropractic Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528623691 | Shannon Monique Roberts | Behavior Technician | 6148 Passionate Ct, N Las Vegas, NV 89031-3538 | 2019-05-04 |
1215496005 | Shannon Ann Roberts | Behavior Technician | 432 West St, Gaylord, MI 49735-8301 | 2019-03-19 |
1629286869 | Shannon Nicole Roberts | Technician | 1813 Flinthill Dr, Columbus, OH 43223-3542 | 2007-05-20 |
1780742916 | Shannon Orlando Roberts | Respite Care | 3657 S Double Echo Rd, Tucson, AZ 85735-5132 | 2006-12-04 |
1255374880 | Shannon Leigh Roberts | Nurse Practitioner | 7744 Conner Rd, Powell, TN 37849-3509 | 2006-06-13 |
1578182101 | Shannon Leigh Roberts | Chiropractor | 11 E Calhoun St, Sumter, SC 29150-4315 | 2020-04-14 |
1073174215 | Shannon Roberts | Behavior Technician | 4196 Douglas Blvd, Granite Bay, CA 95746-5904 | 2019-06-27 |
1467817072 | Shannon Roberts | Specialist | 175 Burdette St, Spartanburg, SC 29307-1003 | 2015-12-24 |
1740535814 | Shannon Dobelbower Roberts | Dentist | 559 Vincent St Bldg 959, Peterson Afb, CO 80914-1541 | 2012-07-16 |
1992931380 | Shannon Roberts | Emergency Medicine | 7435 W Talcott Ave, Resurrection Emergency Medicine Residency Program, Chicago, IL 60631-3707 | 2009-05-31 |
Street Address |
3786 S EAST ST |
City | INDIANAPOLIS |
State | IN |
Zip Code | 46227-1241 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619389970 | Bryan Walters | Chiropractor | 3786 S East St, Indianapolis, IN 46227-1241 | 2014-05-21 |
1043507940 | Cardinal Wellness Services | Chiropractor | 3786 S East St, Indianapolis, IN 46227-1241 | 2011-06-30 |
1942593470 | Cardinal Wellness Services | Family Medicine | 3786 S East St, Indianapolis, IN 46227-1241 | 2011-05-17 |
1861709693 | East Street Spine & Rehab, Inc. | Chiropractor | 3786 S East St, Indianapolis, IN 46227-1241 | 2010-08-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679184477 | Zachry Skinner | Specialist/Technologist | 1683 E Hanna Ave, Indianapolis, IN 46227 | 2020-08-14 |
1104481415 | Corinne Mcdonald | Music Therapist | 7502 Madison Avenue, Indianapolis, IN 46227 | 2019-05-02 |
1205318649 | Kesha Conner | Counselor | 8320 Madison Ave Indianapolis, In, Indianapolis, IN 46227 | 2018-09-01 |
1609369719 | Victoria Lynn West Arnold | Physician Assistant | 1550 E County Line Rd Ste 320, Indianapolis, IN 46227 | 2018-06-13 |
1518466960 | Debra Cottongim | Physical Therapy Assistant | 6329 South East St, Ste A, Indianapolis, IN 46227 | 2018-02-12 |
1962943019 | Fresenius Medical Care Indiana, LLC | Clinic/Center | 6826 Madison Ave, Indianapolis, IN 46227 | 2017-03-09 |
1205386687 | Kylie Rochelle Bontrager | Dentist | 3658 East Street, Indianapolis, IN 46227 | 2016-10-10 |
1013371137 | Kayla Ford | Occupational Therapist | 3230 Rue Chanel, Apt 162, Indianapolis, IN 46227 | 2016-04-06 |
1639551344 | Sara Allyn Shrivastav | Technician, Other | 3711 E Southport Rd, Indianapolis, IN 46227 | 2015-06-18 |
1598146565 | Theodore Christian Seger | Family Medicine | 610 E Southport Rd Ste 205, Indianapolis, IN 46227 | 2015-06-15 |
Find all providers in zip 46227 |
Taxonomy Code | 111N00000X |
Grouping | Chiropractic Providers |
Classification | Chiropractor |
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235737552 | Molly Vyzral | Chiropractor | 8770 Guion Rd Ste L, Indianapolis, IN 46268-3017 | 2020-10-09 |
1912529082 | Traci Gross | Chiropractor | 1460 W 86th St, Indianapolis, IN 46260-2181 | 2020-05-12 |
1154954972 | James Mccluskey | Chiropractor | 5935 Grandiose Dr, Indianapolis, IN 46228-4308 | 2020-02-20 |
1417587890 | Abigail Wade | Chiropractor | 6155 N Keystone Ave Ste 700, Indianapolis, IN 46220-1485 | 2020-01-24 |
1689204174 | Jennifer Brenneisen | Chiropractor | 971 N Delaware St, Indianapolis, IN 46202-3377 | 2020-01-23 |
1467082198 | Arden Burch | Chiropractor | 5111 E 65th St, Indianapolis, IN 46220-4816 | 2020-01-22 |
1053951137 | Restoration Family Chiropractic | Chiropractor | 5915 S Emerson Ave Ste 400, Indianapolis, IN 46237-1972 | 2020-01-07 |
1700432002 | Carter Yoder Chiropractic LLC | Chiropractor | 7855 S Emerson Ave Ste Q, Indianapolis, IN 46237-8669 | 2019-08-13 |
1750935946 | Chiro One Wellness Center of Indianapolis North LLC | Chiropractor | 6612 E 75th St Ste 110, Indianapolis, IN 46250-2821 | 2019-07-26 |
1376026393 | Eric Anthony Wolf | Chiropractor | 410 S Mitthoeffer Rd, Indianapolis, IN 46229-3058 | 2018-09-14 |
Find all providers in INDIANAPOLIS |
City | INDIANAPOLIS |
Zip Code | 46227 |
Please comment or provide details below to improve the information on DR. SHANNON ROBERTS.
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.