DR. SHANNON ANDERSON (NPI# 1376912618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376912618 |
| Entity Type | Individual |
| Full Name | DR. SHANNON ANDERSON |
| Credential | MD |
| Practice Address |
Corner of Route N12 and N7 Fort Defiance AZ 86504 |
| Mailing Address |
1613 W Pacific Coast Hwy Apt 191 Wilmington CA 90744-1867 |
| Practice Telephone | 9287298132 |
| Mailing Telephone | 7144046128 |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2019-12-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | A135859 | CA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 25825 Vermont Ave, Harbor City, CA 907103518 | 3103255111 | |
| 420 34th St, Bakersfield, CA 933012237 | 6613274647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184138471 | Shannon Anderson | Counselor | 33231 Schoolcraft Road Suite 210, Livonia, MI 48150 | 2017-11-22 |
| 1548490444 | Shannon Todd Anderson | Physical Therapist | 12023 Wandsworth Dr, Tampa, FL 33626-2614 | 2009-07-27 |
| 1386267953 | Shannon Anderson | Social Worker | 217 W Georgia Ave Ste 120, Nampa, ID 83686-6812 | 2020-05-18 |
| 1427685098 | Shannon Elizabeth Anderson | Pharmacist | 525 N Galloway Ave, Mesquite, TX 75149-3482 | 2020-03-24 |
| 1710488648 | Shannon Clara Anderson | Nurse Practitioner | 2202 S Park St, Madison, WI 53713-1916 | 2018-02-26 |
| 1922531656 | Shannon Anderson | Licensed Practical Nurse | 3440 Oakwood Hills Pkwy, Eau Claire, WI 54701-7698 | 2017-04-10 |
| 1154865020 | Shannon Anderson | Nurse Practitioner | 1740 Nicholasville Rd, Lexington, KY 40503-1431 | 2016-12-13 |
| 1407224751 | Shannon M Anderson | Speech-Language Pathologist | 1550 State Route 488, Clifton Springs, NY 14432-9308 | 2015-09-03 |
| 1740683416 | Shannon Patricia Anderson | Registered Nurse | 1406 6th Ave N, St Cloud Hospital, Saint Cloud, MN 56303-1900 | 2014-10-08 |
| 1891047155 | Shannon Marie Anderson | Nurse Practitioner | 13101 State Line Rd, Kansas City, MO 64145-1650 | 2012-10-11 |
| Street Address |
CORNER OF ROUTE N12 AND N7 |
| City | FORT DEFIANCE |
| State | AZ |
| Zip Code | 86504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326040577 | John R Thompson | Orthopaedic Surgery | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2005-06-01 |
| 1194348524 | Shanna Michelle George | Respiratory Therapist, Registered | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0589 | 2020-05-20 |
| 1265077267 | Stanislava Manojlovic | Pharmacist | Corner of Route N12 and N7, Fort Defiance Indian Hospital Board, Inc., Fort Defiance, AZ 86504-0649 | 2019-11-13 |
| 1033767371 | Dakota Kay | Physical Therapist | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0649 | 2019-08-29 |
| 1053964452 | Jenny Dietz | Nurse Practitioner | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2019-07-24 |
| 1386296648 | Tessa Tahereh Facer | Physician Assistant | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0649 | 2019-07-16 |
| 1346892056 | Amanda Barnes | Physician Assistant | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0649 | 2019-07-12 |
| 1295206779 | Craig Amidon Fox | Physical Therapist | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2018-12-10 |
| 1134698517 | Christa Lee | Advanced Practice Midwife | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0649 | 2018-11-15 |
| 1518440007 | Ethan Curleyhair | Dentist | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2018-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807664 | Clifford Charles | Pharmacist | Corners of Route 7&12, Fort Defiance, AZ 86504 | 2020-10-06 |
| 1720605207 | Christopher A Will | Registered Nurse | 2126-1 Shandiin Circle, Fort Defiance, AZ 86504 | 2020-06-30 |
| 1750904207 | Crystal Salaz | Respiratory Therapist, Registered | Corner of Roue N12 and N7, Fort Defiance, AZ 86504 | 2020-05-19 |
| 1003451600 | Rebecca Reeve | Pharmacist | Tsehootsooi Medical Center, Corner of Indian Route 7 and 12, Fort Defiance, AZ 86504 | 2019-11-07 |
| 1851947485 | David Glen Webb | Pharmacist | Hwy 12 Nr 110, Fort Defiance, AZ 86504 | 2019-08-09 |
| 1952963647 | Eukerison Bobby Tsinajinie | Counselor | .25 Miles S Fieldhouse Ra 6905, Fort Defiance, AZ 86504 | 2019-07-02 |
| 1770145567 | Joann Tso I | Counselor | 1/4 Mile Ne of Ft. Defiance Fieldhouse, Ft. Defiance, AZ 86504 | 2019-07-02 |
| 1174185961 | James Leslie | Counselor | 1/4 Mile South of Ft Defiance Fieldhouse Ra#6905, Ft Defiance, AZ 86504 | 2019-07-02 |
| 1184192163 | Miranda Frances Blatchford | Social Worker | .5 Miles Sw of The Fd Field House, Bldg #6905, Fort Defiance, AZ 86504 | 2018-11-07 |
| 1477030914 | Michelle Rosario | Dietitian, Registered | Fort Defiance Indian Hospital Board, Inc., Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2018-07-27 |
| Find all providers in zip 86504 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073673166 | Brian Ezar Cooper | Emergency Medicine | Corner of Rt N7 and N12, Fort Defiance, AZ 86504-0649 | 2006-12-11 |
| 1023183241 | Tyrone Harold Walker | Emergency Medicine | Corner of Rte N 12 and N 7, Fort Defiance, AZ 86504 | 2006-11-22 |
| 1710978176 | Frank P Ammesmaki | Emergency Medicine | Corner of Route 12 and Route 7, Emergency Department, Fort Defiance, AZ 86504-0649 | 2005-11-03 |
| 1558749309 | Jordan Cohen | Emergency Medicine | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0649 | 2015-05-13 |
| 1255745113 | Elyssa Berg | Emergency Medicine | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2014-06-18 |
| 1851702054 | Alexander Scott Whelan | Emergency Medicine | Corner of Routes N12 & N7, Fort Defiance, AZ 86504 | 2014-05-12 |
| 1649699125 | Ryan Mason | Emergency Medicine | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2014-04-10 |
| 1669523890 | Barry Edwards | Emergency Medicine | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2007-01-15 |
| 1003963265 | Romulo Laureta Parungao | Emergency Medicine | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2007-01-03 |
| 1427119502 | Charles Adams Blakely | Emergency Medicine | Fort Defiance Indian Hospital, Corner Route N7 and N12, Fort Defiance, AZ 86504 | 2006-12-13 |
| Find all providers in FORT DEFIANCE | ||||
| City | FORT DEFIANCE |
| Zip Code | 86504 |
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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.