DR. SHANAN LOE (NPI# 1437125093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437125093 |
| Entity Type | Individual |
| Full Name | DR. SHANAN LOE |
| Credential | M.D. |
| Practice Address |
4203 Belfort Road Suite 204 Jacksonville FL 32216-1463 |
| Practice Telephone | 9042965688 |
| Practice Fax Number | 9042965699 |
| Mailing Telephone | 9042965688 |
| Mailing Fax Number | 9042965699 |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2014-05-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | ME93888 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 788979252A | 05 | |
| FL | 2732653-00 | 05 |
| Street Address |
4203 BELFORT ROAD SUITE 204 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216-1463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255513909 | Manpreet Singh Grewal | Surgery | 4203 Belfort Road, Suite 215, Jacksonville, FL 32216-1416 | 2007-12-04 |
| 1982769295 | Richard Donald Wetmore | Family Medicine | 4203 Belfort Road, Suite 315, Jacksonville, FL 32216-1418 | 2006-12-27 |
| 1831284645 | Abdallah I Kafrouni | Internal Medicine | 4203 Belfort Road, Suite 215, Jacksonville, FL 32216-1416 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396108528 | Michelle Melanson | Obstetrics & Gynecology | 14546 Old Saint Augustine Rd Ste 305-311, Jacksonville, FL 32258-5468 | 2016-04-04 |
| 1316387947 | Alexander David Raw | Obstetrics & Gynecology | 1600 W Walnut St Bldg 3, Jacksonville, IL 62650-1136 | 2013-06-27 |
| 1912260613 | Paulami Guha | Obstetrics & Gynecology | 836 Prudential Dr Ste 1600, Jacksonville, FL 32207 | 2012-06-19 |
| 1689963696 | Dawn M Mormak | Obstetrics & Gynecology | 836 Prudential Dr Ste 1506, Jacksonville, FL 32207-8342 | 2011-03-30 |
| 1710210745 | Niamh A Condon | Obstetrics & Gynecology | 653-1 W 8th St # L-17, Jacksonville, FL 32209-6511 | 2009-09-09 |
| 1356531396 | Coastal Ob Gyn and Infertility | Obstetrics & Gynecology | 114a Memorial Dr, Jacksonville, NC 28546-6328 | 2007-07-26 |
| 1871614057 | Aida A. Malonzo | Obstetrics & Gynecology | 1512 Palm Ave, Jacksonville, FL 32207-2916 | 2007-04-03 |
| 1487717864 | Geoffrey Gillen | Obstetrics & Gynecology | 653 W 8th St # L17, Jacksonville, FL 32209-6511 | 2006-12-18 |
| 1306916580 | Jason R Thompson | Obstetrics & Gynecology | 6885 Belfort Oaks Place Ste 210, Jacksonville, FL 32216 | 2006-11-08 |
| 1154400554 | Charles Burk | Obstetrics & Gynecology | 203 Nacogdoches St Ste 210, Jacksonville, TX 75766-2455 | 2006-11-04 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
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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.