SHIVASHANKER PC (NPI# 1306083324) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306083324 |
| Entity Type | Organization |
| Organization Name | SHIVASHANKER PC |
| Other Organization Name | PARKWAY MEDICAL CLINIC |
| Practice Address |
7695 Highpoint Dr Jonesboro GA 30236 |
| Mailing Address |
406 Forest Pkwy Ste A Forest Park GA 30297-2190 |
| Practice Telephone | 4043613100 |
| Practice Fax Number | 4043613141 |
| Mailing Telephone | 4043613100 |
| Mailing Fax Number | 4043613141 |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2009-01-13 |
| Authorized Official Name | MRS. VALENCIA W FLOURNOY (ADMINISTRATOR) |
| Authorized Official Telephone | 4045792188 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 034881 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000477287K | 05 |
| Other Name | Type Code |
|---|---|
| PARKWAY MEDICAL CLINIC | Doing Business As Name - Organization |
| Street Address |
7695 HIGHPOINT DR |
| City | JONESBORO |
| State | GA |
| Zip Code | 30236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123362 | Life Source Counseling & Consulting, LLC | Clinic/Center | 118 North Avenue, Suite A, Jonesboro, GA 30236 | 2020-04-25 |
| 1639609555 | New Beginnings Behavioral Counseling,llc | Social Worker | 9456 S Main St Ste E2, Jonesboro, GA 30236 | 2017-06-13 |
| 1437696762 | Clarissa Alexandra Poole | Counselor | 2106 Fair Ridge Ct, Jonesboro, GA 30236 | 2017-01-25 |
| 1588012892 | Sundance Healthcare Service Inc | In Home Supportive Care | 7861 Collinswood Court, Jonesboro, GA 30236 | 2016-05-26 |
| 1942669205 | Adrianne Smiley Gurley | Occupational Therapist | 1299 Battlecreek Rd Ste 210, Jonesboro, GA 30236 | 2016-02-15 |
| 1336505809 | Integrated Health Center | Dentist | 8600 Tara Blvd, Suite D, Jonesboro, GA 30236 | 2016-01-13 |
| 1467827402 | Surrell Porter | Nurse Practitioner | 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 | 2015-12-02 |
| 1740688910 | Jacqueline Carolyn Edwards | Registered Nurse | 8081 Tara Blvd, 265, Jonesboro, GA 30236 | 2014-12-19 |
| 1770991861 | Lower Extremity Diagnostics, LLC | Podiatrist | 6911 Tara Boulevard, Jonesboro, GA 30236 | 2014-08-01 |
| 1760899710 | Fresenius Medical Care Jonesboro, LLC | Clinic/Center | 8060 Summitt Business Parkway, Jonesboro, GA 30236 | 2014-07-22 |
| Find all providers in zip 30236 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154873545 | Camille C Chan | Pediatrics | 1150 E Matthews Ave Ste 101, Jonesboro, AR 72401-4356 | 2016-11-01 |
| 1962583013 | Marvin Lowery Beck | Pediatrics | 3203 Methodist Drive, Jonesboro, AR 72403-9069 | 2006-10-17 |
| 1962469254 | Jane M Sneed | Pediatrics | 800 S Church St Ste 400, Jonesboro, AR 72401-4112 | 2006-04-28 |
| 1003881848 | Vye Branch Watson | Pediatrics | 2707 Browns Lane, Jonesboro, AR 72401 | 2006-02-22 |
| 1689665895 | Jocelyn Daisy Collins | Pediatrics | 2400 Mt Zion Parkway, Southwood Medical Center Department of After Hours, Jonesboro, GA 30236 | 2005-11-04 |
| 1134121635 | Pediatric Associates of Jonesboro, Pllc | Pediatrics | 1150 E Matthews Ave, Suite 101, Jonesboro, AR 72401-4314 | 2005-08-15 |
| 1306845490 | Maria Teresa A Coleman | Pediatrics | 236 Arrowhead Blvd, Jonesboro, GA 30236-1106 | 2005-07-20 |
| 1194282822 | Kion Pediatrics | Pediatrics | 3410 E Johnson Ave Ste T, Jonesboro, AR 72401-2032 | 2019-02-28 |
| 1285198507 | Tanika D Jarrett | Pediatrics | 3203 Methodist Dr, Jonesboro, AR 72401-7434 | 2019-01-31 |
| 1124448782 | Christine Dehnert Kofman | Pediatrics | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2014-04-22 |
| Find all providers in JONESBORO | ||||
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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.