SHANNON R VAUGHN (NPI# 1306006929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306006929 |
| Entity Type | Individual |
| Full Name | SHANNON R VAUGHN |
| Credential | NP |
| Practice Address |
300 E Jefferson St Suite 101 Boise ID 83712-6246 |
| Mailing Address |
190 E Bannock St Boise ID 83712-6241 |
| Practice Telephone | 2083221680 |
| Practice Fax Number | 2086852282 |
| Mailing Telephone | 2083364141 |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2012-08-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
NP870A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083926166 | Shannon Mckala Vaughn | Speech-Language Pathologist | 1486 Bailee Way Sw, Jacksonville, AL 36265-3318 | 2010-07-06 |
| 1063927747 | Shannon Wade Vaughn | Registered Nurse | 210 W Main St, Union, SC 29379-2215 | 2017-12-04 |
| 1164448809 | Shannon Joe Vaughn | Family Medicine | 28 John Davenport Dr Nw, Rome, GA 30165-2536 | 2006-07-14 |
| Street Address |
300 E JEFFERSON ST SUITE 101 |
| City | BOISE |
| State | ID |
| Zip Code | 83712-6246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134199631 | Cherish L Smith | Physician Assistant | 300 E Jefferson St, Suite 300, Boise, ID 83712-6246 | 2006-01-25 |
| 1962958892 | Brittany Matthews | Nurse Practitioner | 300 E Jefferson St, #300, Boise, ID 83712-6246 | 2016-08-31 |
| 1013396266 | Emily Barnett | Social Worker | 300 E Jefferson St, Boise, ID 83712-6246 | 2015-05-20 |
| 1437583408 | Andrea L Bockenstette | Nurse Practitioner | 300 E Jefferson St, Ste 101, Boise, ID 83712-6246 | 2013-08-27 |
| 1639519853 | Sara M O'connor | Nurse Practitioner | 300 E Jefferson St, Suite 101, Boise, ID 83712-6246 | 2013-07-02 |
| 1295027688 | Jodie L. Donovan | Internal Medicine | 300 E Jefferson St, Suite 300, Boise, ID 83712-6246 | 2011-05-04 |
| 1396071056 | Sorcha M Cusack | Physician Assistant | 300 E Jefferson St, Ste 300, Boise, ID 83712-6246 | 2009-10-29 |
| 1255574109 | Roger Thomas Turcotte Jr. | Internal Medicine | 300 E Jefferson St, Suite 201, Boise, ID 83712-6246 | 2009-04-08 |
| 1396916417 | St. Luke's Regional Medical Center | Nurse Practitioner | 300 E Jefferson St, Suite 101, Boise, ID 83712-6246 | 2008-03-17 |
| 1669666939 | St Lukes Regional Medical Center | Clinic/Center | 300 E Jefferson St, Boise, ID 83712-6246 | 2007-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477016012 | Veranda At Barber Station LLC | Assisted Living Facility | 3266 E. Barber Valley Drive, Boise, ID 83712 | 2019-04-10 |
| 1891258612 | Mary Elizabeth Riedel | Occupational Therapist | 190 E Bancock St., Boise, ID 83712 | 2019-04-09 |
| 1427523968 | Q17 Health Partners LLC | Surgery | 100 East Idaho Street #317, Boise, ID 83712 | 2018-10-11 |
| 1053898247 | Travis Dale Worwood | Social Worker | South Entrance, 1075 E. Park Blvd, Boise, ID 83712 | 2018-07-20 |
| 1689166761 | Kristen Nicole Ray | Social Worker | 109 E Bannock St, Boise, ID 83712 | 2018-06-04 |
| 1740706894 | Meghan Heitstuman | Social Worker | 190 E Bannock Street, Boise, ID 83712 | 2017-08-21 |
| 1942759725 | Kay Craig | Physical Therapist | 190 Bannock, Boise, ID 83712 | 2016-09-22 |
| 1235686395 | Sharon Bjornson | Physical Therapist | 190 East Bannack, Boise, ID 83712 | 2016-09-07 |
| 1033576491 | Heather Hussey | Genetic Counselor, MS | 100 E Idaho Street, Msti Genetics, Boise, ID 83712 | 2016-01-15 |
| 1295139137 | Amie Bartholomeus | Massage Therapist | 100 East Idaho Street, St Luke's Mountain States Tumor Institute, Boise, ID 83712 | 2014-10-21 |
| Find all providers in zip 83712 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881017382 | Joniruth Digaum | Nurse Practitioner | 8040 S Red Cliff Ave, Boise, ID 83716-3466 | 2014-02-04 |
| 1790119238 | Illaria C Moore | Nurse Practitioner | 11050 Montana Ave, Boise, ID 83713-5049 | 2013-08-31 |
| 1851438006 | Gregory C Galloway | Nurse Practitioner | 5440 W Franklin Rd, Suite 100, Boise, ID 83705-1079 | 2007-01-30 |
| 1154436426 | Amy Hoffmann | Nurse Practitioner | 3210 N Mountain View Dr, Boise, ID 83704-4635 | 2006-08-20 |
| 1598774275 | Barbara L Irish | Nurse Practitioner | 1000 N Curtis Road, Suite 305, Boise, ID 83706 | 2006-08-05 |
| 1225020993 | April D Southwick | Nurse Practitioner | 703 S Americana Blvd, Ste 130, Boise, ID 83702-5099 | 2005-08-18 |
| 1316558596 | Jonathan Adar Shectman | Nurse Practitioner | 500 W Fort St, Boise, ID 83702-4501 | 2020-08-12 |
| 1336762566 | Treasure Valley Healthcare Pllc | Nurse Practitioner | 5108 N Maidstone Way, Boise, ID 83713-1367 | 2020-05-21 |
| 1902459266 | Melissa Adele Wren Perry | Nurse Practitioner | 300 S 23rd St, Boise, ID 83702-9100 | 2019-07-16 |
| 1144702796 | Michelle Ann Mcneley | Nurse Practitioner | 500 W Fort St, Boise, ID 83702-4599 | 2018-08-30 |
| Find all providers in BOISE | ||||
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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.