MRS. SHANNON RUTH ERVIN (NPI# 1386606028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386606028 |
| Entity Type | Individual |
| Full Name | MRS. SHANNON RUTH ERVIN |
| Other Name | MISS SHANNON RUTH LOWE |
| Credential | PA-C |
| Practice Address |
3623 Latrobe Dr Suite 216 Charlotte NC 28211 |
| Mailing Address |
Po Box 221249 Charlotte NC 28222-1249 |
| Practice Telephone | 7043321291 |
| Practice Fax Number | 7043325206 |
| Mailing Telephone | 7043321291 |
| Mailing Fax Number | 7043325206 |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2020-09-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
103580 | NC | Allopathic & Osteopathic Physicians |
| Y | 363A00000X | Physician Assistant | 103580 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3623 LATROBE DR SUITE 216 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881685063 | Jay Waldron Patti | Radiology | 3623 Latrobe Dr, Suite 216, Charlotte, NC 28211 | 2005-11-04 |
| 1528500220 | Unique Communicators Speech and Language Therapy Center, Pllc | Speech-Language Pathologist | 3623 Latrobe Dr, Suite 110 A-4, Charlotte, NC 28211-4864 | 2016-11-11 |
| 1386004513 | Caitlin Volchansky Moody | Radiology | 3623 Latrobe Dr, Suite 216, Charlotte, NC 28211 | 2016-03-01 |
| 1750755567 | Sarah Patterson | Radiology | 3623 Latrobe Dr, Suite 216, Charlotte, NC 28211-4864 | 2015-11-17 |
| 1467844613 | Brandon B Alspaugh | Radiology | 3623 Latrobe Dr, Charlotte, NC 28211-4864 | 2015-02-25 |
| 1669863478 | Allyson Kaye Norwood | Radiology | 3623 Latrobe Dr, Suite 216, Charlotte, NC 28211-4864 | 2015-02-16 |
| 1184961633 | Joshua Daniel Russ | Physician Assistant | 3623 Latrobe Dr, Suite 216, Charlotte, NC 28211-4864 | 2013-01-03 |
| 1518245752 | Nc Psychiatric Associates, Pllc | Psychiatry & Neurology | 3623 Latrobe Dr, Suite #121, Charlotte, NC 28211-4864 | 2011-07-21 |
| 1154658508 | Progressive Care LLC | Nursing Care | 3623 Latrobe Dr, Suite 105, Charlotte, NC 28211-4864 | 2009-11-05 |
| 1477792182 | Heather Jane Kaneda | Radiology | 3623 Latrobe Dr, Suite 216, Charlotte, NC 28211 | 2009-02-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184277832 | I and J Wheelchair Transportation | Non-emergency Medical Transport (VAN) | 1512 Delane Avenue, Charlotte, NC 28211 | 2019-07-22 |
| 1922563923 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 447 Billingsley Rd, Cottage A, Charlotte, NC 28211 | 2019-02-04 |
| 1649798273 | Ally Home Care Charlotte LLC | In Home Supportive Care | 3711 Latrobe Drive Suite 520, Charlotte, NC 28211 | 2017-09-04 |
| 1154866770 | Vaibhav Bajaj | Dentist | 2809 Coltsgate Rd Ste 200, Charlotte, NC 28211 | 2017-01-05 |
| 1508254939 | Lindsay Marie Smits | Speech-Language Pathologist | 427 N. Wendover Rd., Charlotte, NC 28211 | 2015-01-08 |
| 1457755480 | Kristen Hammer | Physical Therapy Assistant | 4120 Providence Rd Apt D, Charlotte, NC 28211 | 2014-10-20 |
| 1669805610 | Carla Elizabeth Scott | Physical Therapist | 3500 Ellington Street, Dr. Carlton Watkins Center, Charlotte, NC 28211 | 2013-08-14 |
| 1760726368 | Jill Hensdale Shipp | Social Worker | 307 Hunter Lane, Charlotte, NC 28211 | 2012-11-20 |
| 1346592722 | Danielle Marie Benoit | Occupational Therapist | 3541 Randolph Road Suite 100 W, Charlotte, NC 28211 | 2012-10-09 |
| 1487910832 | John Joseph Marcel Jr. | Orthopaedic Surgery | 449 North Wendover Rd Ste A, Charlotte, NC 28211 | 2012-04-10 |
| Find all providers in zip 28211 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396351607 | Michael James Blackwell | Physician Assistant | 501 Billingsley Rd Ste B, Charlotte, NC 28211-1009 | 2020-09-22 |
| 1598371320 | Jonathan Byron Lively | Physician Assistant | 1000 Blythe Blvd Fl 3, Charlotte, NC 28203-5812 | 2020-09-17 |
| 1902415532 | Jacqueline Ellen Leyrer | Physician Assistant | 2630 E 7th St Ste 200, Charlotte, NC 28204-4319 | 2020-07-29 |
| 1750908380 | Whitney Debroy | Physician Assistant | 125 W Tremont Ave Unit 726, Charlotte, NC 28203-5551 | 2020-06-30 |
| 1972129302 | Ashley Nicole Short | Physician Assistant | 1022 E Worthington Ave, Charlotte, NC 28203-5760 | 2020-06-22 |
| 1558985176 | Courtney Claugus | Physician Assistant | 300 E Park Ave Unit 7, Charlotte, NC 28203-4774 | 2020-05-29 |
| 1467071738 | Patrick James Quinn | Physician Assistant | 2036 Millerton Ave Apt 4311, Charlotte, NC 28208-5290 | 2020-04-15 |
| 1225660301 | Sunil Ranchhod Ghodasara | Physician Assistant | 1001 Blythe Blvd Ste 403, Charlotte, NC 28203-5863 | 2020-02-06 |
| 1225668601 | Emily Rebecca Markey | Physician Assistant | 355 W Mlk Blvd Apt 1112, Charlotte, NC 28202-0043 | 2020-01-24 |
| 1639719586 | Abosede Elizabeth Adamson | Physician Assistant | 3101 Amesbury Hill Dr, Charlotte, NC 28269-8951 | 2020-01-08 |
| Find all providers in CHARLOTTE | ||||
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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.