SHANNON WANG CLARK (NPI# 1316258569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316258569 |
| Entity Type | Individual |
| Full Name | SHANNON WANG CLARK |
| Credential | MD |
| Practice Address |
1000 Walnut St 1506 Philadelphia PA 19107-5795 |
| Practice Telephone | 8135274403 |
| Mailing Telephone | 8135274403 |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2017-06-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | MT197142 | PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366931552 | Shannon Clark | Registered Nurse | 8201 S 61st St, Lincoln, NE 68516-5994 | 2018-05-03 |
| 1457786675 | Shannon Clark | Occupational Therapy Assistant | 860 W 132nd Ave, Spc 268, Westminster, CO 80234-1499 | 2013-09-06 |
| 1881726271 | Shannon Denise Clark | Nurse Practitioner | 2 Easton Oval Ste 450, Columbus, OH 43219-6035 | 2007-03-12 |
| 1760537617 | Shannon Renee Clark | Nurse Practitioner | 3128 Santa Rita Rd, Suite C, Pleasanton, CA 94566-8300 | 2007-01-23 |
| 1700940855 | Shannon Jackie Clark | Contractor | 10750 S Knoll Crest Ln, Tucson, AZ 85706-9052 | 2006-12-21 |
| 1720089311 | Shannon Lynn Clark | Chiropractor | 423 Main St, Reinbeck, IA 50669-1049 | 2005-08-03 |
| 1487149373 | Shannon Clark | Counselor | 90 Hospital Dr, Athens, OH 45701-2301 | 2018-06-25 |
| 1679021448 | Shannon Lorraine Clark | Speech-Language Pathologist | 2251 E Paris Ave Se, Grand Rapids, MI 49546-2431 | 2016-09-21 |
| 1508299777 | Shannon Joan Clark | Nurse Practitioner | 3604 Bush St, Raleigh, NC 27609-7511 | 2013-08-12 |
| 1770916033 | Shannon M Clark | Specialist/Technologist, Other | 3 Maryland Farms Ste 200, Brentwood, TN 37027-5780 | 2013-08-09 |
| Street Address |
1000 WALNUT ST 1506 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-5795 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497280317 | Nikita Desai | Student in an Organized Health Care Education/Training Program | 1000 Walnut St, Apt 1003, Philadelphia, PA 19107-5795 | 2017-04-28 |
| 1538589460 | Brandon Kujawski | Student in an Organized Health Care Education/Training Program | 1000 Walnut St, Apartment 1400, Philadelphia, PA 19107-5795 | 2014-04-18 |
| 1467671388 | Nirav Patel | Radiology | 1000 Walnut St, Apt. 909, Philadelphia, PA 19107-5517 | 2007-04-25 |
| 1427179779 | Aida Tesfaye-kedjela | Anesthesiology | 1000 Walnut St, Apt 1105, Philadelphia, PA 19107-5517 | 2007-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1003475120 | Michael Bradley Avery | Neurological Surgery | 909 Walnut Street, 2nd Floor, Philadelphia, PA 19107-5211 | 2019-06-12 |
| 1225370869 | Endrit Ziu | Neurological Surgery | 929 N 29th St, Apt 103, Philadelphia, PA 19130-1110 | 2013-03-21 |
| 1760617054 | Gentian Toshkezi | Neurological Surgery | 3998 Red Lion Rd Ste 213, Philadelphia, PA 19114 | 2009-05-15 |
| 1295900942 | Zarina S Ali | Neurological Surgery | 3400 Spruce Street Hup - Dept of Neurosurgery, 3 Silverstein, Philadelphia, PA 19104 | 2008-04-24 |
| 1629286018 | Stavropoula Ioannis Tjoumakaris | Neurological Surgery | 909 Walnut Street, 2rd Floor, Jefferson Neurosurgical Associates, Philadelphia, PA 19107-5211 | 2007-05-18 |
| 1639299837 | Neurosurgical Associates | Neurological Surgery | 5049 Oxford Ave, Philadelphia, PA 19124-2652 | 2007-03-30 |
| 1801910310 | Merylee Elizabeth Werthan | Neurological Surgery | 5049 Oxford Avenue, Philadelphia, PA 19124-2652 | 2007-03-19 |
| 1629132006 | Srinivas Kasinadhuni Prasad | Neurological Surgery | 909 Walnut St Fl 2, Philadelphia, PA 19107-5211 | 2006-12-20 |
| 1255403747 | Silva Markovic-plese | Neurological Surgery | 900 Walnut St Fl 2, Philadelphia, PA 19107-5509 | 2006-11-14 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
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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.