SHANNON WALDON (NPI# 1336555051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336555051 |
| Entity Type | Individual |
| Full Name | SHANNON WALDON |
| Credential | CSA |
| Practice Address |
510 Lincoln Dr Herrin IL 62948-6334 |
| Mailing Address |
4787 Alben Barkley Dr Paducah KY 42001-6789 |
| Practice Telephone | 6189976800 |
| Practice Fax Number | 6189971187 |
| Mailing Telephone | 2704429461 |
| Mailing Fax Number | 2704410079 |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2014-09-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZS0410X |
Specialist/Technologist, Other Specialization: Surgical Technologist |
4393 | KY | Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881240489 | Shannon Waldon | Pharmacist | 15929 Airline Hwy, Baton Rouge, LA 70817-7448 | 2019-08-11 |
| Street Address |
510 LINCOLN DR |
| City | HERRIN |
| State | IL |
| Zip Code | 62948-6334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023001377 | Southern Illinois Orthopedic Center,llc | Clinic/Center | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2005-08-23 |
| 1629682471 | Rachel Peterson | Physical Therapist | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2020-08-31 |
| 1679119572 | Marcia Skinner | Physical Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-26 |
| 1790321602 | Braden Reeves | Physical Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-26 |
| 1508402652 | Joshua Sheldon | Physical Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-25 |
| 1801432968 | Sydney Allen | Physical Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-25 |
| 1487290532 | Michelle Reed | Occupational Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-25 |
| 1689235715 | Michelle Steh | Nurse Practitioner | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-06-28 |
| 1427576180 | Amelie H Wilson | Physical Therapist | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2017-09-01 |
| 1790238160 | Kali Jo Moe | Nurse Practitioner | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2016-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215307590 | Carmelito Miralles Caronongan | Pediatrics | 120 S. 11th St., Herrin, IL 62948 | 2015-09-30 |
| 1073995684 | Motaz R Wraikat | Preventive Medicine | 315 S 13th St Ste 3, Herrin, IL 62948 | 2015-06-19 |
| 1639427933 | Salim Hosein | Surgery | 317 S 14th St Ste 1, Herrin, IL 62948 | 2012-08-17 |
| 1962780288 | Pooja Sareen | Internal Medicine | 3024 S Park Avenue, Herrin, IL 62948 | 2011-08-03 |
| 1235459918 | Timoteo Castro Md & Josefina D. Castro Md Ltd | Family Medicine | 321 South 13st St., Herrin, IL 62948 | 2010-06-04 |
| 1457501926 | Don Cassidy Arnold II | Urology | 220 S Park Ave Fl 2, Herrin, IL 62948 | 2008-09-22 |
| 1306094560 | Karl Keith Mitchener | Speech-Language Pathologist | 1901 N 13th Street, Herrin, IL 62948 | 2008-08-29 |
| 1457509705 | Kathryn Marie Bordenet-jines | Occupational Therapy Assistant | 1901 N. 13th, Herrin, IL 62948 | 2008-08-28 |
| 1417105776 | Cheryl Lynn Matic | Occupational Therapy Assistant | 1901 N. 13th St., Herrin, IL 62948 | 2008-08-28 |
| 1174771422 | Mary Frances Graham | Physical Therapy Assistant | 1901 N. 13th Street, Herrin, IL 62948 | 2008-08-28 |
| Find all providers in zip 62948 | ||||
| Taxonomy Code | 246ZS0410X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Surgical Technologist |
| Surgical technologists are allied health professionals, who are an integral part of the team of medical practitioners providing surgical care to patients. Surgical technologists work under the supervision of a surgeon to facilitate the safe and effective conduct of invasive surgical procedures, ensuring that the operating room environment is safe, that equipment functions properly, and that the operative procedure is conducted under conditions that maximize patient safety. Surgical technologists possess expertise in the theory and application of sterile and aseptic technique and combine the knowledge of human anatomy, surgical procedures, and implementation tools and technologies to facilitate a physician's performance of invasive therapeutic and diagnostic procedures. |
| Notes: Source: Association of Surgical Technologists, "Job Description: Surgical Technologist," 2014. [7/1/2014: code modified, title modified, definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073075420 | Deborah Kay Schroh | Specialist/Technologist, Other | 2350 Ravine Way Ste 400, Glenview, IL 60025-7621 | 2019-04-04 |
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1427508076 | Mitchell Bogda | Specialist/Technologist, Other | 132 Bertram Dr Unit K, Yorkville, IL 60560-3212 | 2016-10-06 |
| 1972960193 | Kayla Rushing | Specialist/Technologist, Other | 101 S Birkey St, Goodfield, IL 61742-9631 | 2016-01-19 |
| 1174953186 | Christine Smith | Specialist/Technologist, Other | 12701 W 143rd St Ste 200, Homer Glen, IL 60491-7723 | 2013-11-13 |
| 1114356557 | Vladimir Stalev | Specialist/Technologist, Other | 5978 N Lincoln Ave Apt 2c, Chicago, IL 60659-3747 | 2013-11-06 |
| 1760811665 | Allan Cortes | Specialist/Technologist, Other | 807 Ann St, Joliet, IL 60435-0400 | 2013-11-01 |
| 1972942258 | Viktor Tabatchyk | Specialist/Technologist, Other | 109 Frank Lloyd Wright Ln, Oak Park, IL 60302-2644 | 2013-06-19 |
| 1316280514 | Lyubov Andrushkiv | Specialist/Technologist, Other | 840 N Oakley Blvd Apt 2, Chicago, IL 60622-4735 | 2013-04-05 |
| 1104166875 | Amit Riman | Specialist/Technologist, Other | 1851 President St, Glendale Heights, IL 60139-1978 | 2013-02-18 |
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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.