SHELBY ANDERSON (NPI# 1558896126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558896126 |
| Entity Type | Individual |
| Full Name | SHELBY ANDERSON |
| Practice Address |
530 Ne Glen Oak Ave Peoria IL 61637-0001 |
| Practice Telephone | 3096557257 |
| Mailing Telephone | 3096557257 |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2017-04-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484106 | Shelby Nicole Anderson | Occupational Therapist | 2208 E Main St, Murfreesboro, TN 37130-5800 | 2020-07-09 |
| 1528628062 | Shelby K Anderson | Optometrist | 1621 S Minnesota Ave, Sioux Falls, SD 57105-1743 | 2019-06-17 |
| 1356906622 | Shelby Anderson | Behavior Technician | 5945 S Los Altos Pkwy Ste 101, Sparks, NV 89436-2503 | 2019-05-02 |
| 1780155721 | Shelby Victoria Anderson | Case Manager/Care Coordinator | 2970 Sw Avalon Way, Seattle, WA 98126-2551 | 2018-12-17 |
| 1114495991 | Shelby Sutton Anderson | Pharmacist | 4500 S Lancaster Rd, Dallas, TX 75216-7167 | 2018-11-09 |
| 1922513985 | Shelby Kathryn Anderson | Student in an Organized Health Care Education/Training Program | 1 Medical Center Dr, Morgantown, WV 26506-1200 | 2017-12-12 |
| 1740701630 | Shelby Anderson | Behavior Technician | 193 Market St, Kingston, PA 18704-5409 | 2017-06-29 |
| 1851675466 | Shelby N Anderson | Speech-Language Pathologist | 605 Jefferson Davis Hwy, Fredericksburg, VA 22401-8403 | 2011-09-30 |
| 1538490040 | Shelby Leigh Anderson | Counselor | 340 Main St, Worcester, MA 01608-1604 | 2010-01-22 |
| 1255495768 | Shelby Anderson | Physical Therapy Assistant | 2700 Westside Dr Nw, Suite 103, Cleveland, TN 37312-3699 | 2006-12-20 |
| Street Address |
530 NE GLEN OAK AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61637-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346235777 | Jack Michael Gibson | Obstetrics & Gynecology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2005-09-12 |
| 1053912188 | Janie Clary | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-11-04 |
| 1265030548 | Christina David | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-10-09 |
| 1033726831 | Corry Lynn Rediger | Occupational Therapist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-09-25 |
| 1720694094 | Katelynn M Madden | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-09-21 |
| 1568074474 | Amanda Diane Beoletto | Pharmacist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-08-21 |
| 1881212892 | Mohammad Mousbah Al-tabbaa | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-07-07 |
| 1750909693 | Mohammad Gareeb | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-07-07 |
| 1376160846 | Bassel Elia Abouzeid | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637 | 2020-07-01 |
| 1700403516 | Christina Marie Spurgeon | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780200865 | Kuang Chuen Liu | Pediatrics | 530 Ne Glen Oak Ave, Peoria, Peoria, IL 61637 | 2020-06-24 |
| 1174184527 | Manisha Tharoor | Student in an Organized Health Care Education/Training Program | 530 N.e Glen Oak Ave, Peoria, IL 61637 | 2019-06-26 |
| 1609436724 | Sriviji Senthil Kumaran | Student in an Organized Health Care Education/Training Program | 530. N.e Glen Oak Ave., Peoria, IL 61637 | 2019-06-20 |
| 1780240929 | Abuzar Ali Asif | Student in an Organized Health Care Education/Training Program | 530 N. E. Glen Oak Ave., Peoria, IL 61637 | 2019-05-14 |
| 1518328665 | Jenna Bishop | Dietitian, Registered | 600 Ne Water Street, Peoria, IL 61637 | 2016-03-17 |
| 1194133850 | Ashish Kumar Roy | Internal Medicine | 530 N.e. Glen Oak Ave, Peoria, IL 61637 | 2014-07-25 |
| 1265720510 | Reuben Antony | Pediatrics | 530 Ne Glen Oak Ave., C/o Ms Suzy Lewellen, Peoria, IL 61637 | 2011-07-20 |
| 1366673436 | Joseph William Hauter | Emergency Medicine | 830 Ne Glen Oak Ave, Peoria, IL 61637 | 2009-08-06 |
| 1437380748 | Jeremy R Monroe | Emergency Medicine | 530 Glen Oak, Osf St Francis Medical Center, Peoria, IL 61637 | 2009-08-04 |
| 1326244682 | Maria S. Parr | Psychiatry & Neurology | Osf Saint Francis Medical Center, 530 N.e.glen Oak Ave., Peoria, FL 61637 | 2007-06-25 |
| Find all providers in zip 61637 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821609751 | Amanda Ferreira | Student in an Organized Health Care Education/Training Program | 7421 W Shangri La Rd, Peoria, AZ 85345-5811 | 2020-08-13 |
| 1699396838 | Ashif Khaled Molla | Student in an Organized Health Care Education/Training Program | Osf St Francis Medical Center 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-04-28 |
| 1437779063 | Mena Henien | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave Bldg 5676, Peoria, IL 61637-0001 | 2020-04-23 |
| 1306465893 | Sarath Kumar Jaganathan Jaishankar | Student in an Organized Health Care Education/Training Program | 530 Ne Glenn Oak Avenue, Peoria, IL 61637-0001 | 2020-04-14 |
| 1952920522 | Phu Si Huynh | Student in an Organized Health Care Education/Training Program | 331 Fulton St Apt 302, Peoria, IL 61602-1436 | 2020-04-13 |
| 1730736604 | Gabriela C Isenia | Student in an Organized Health Care Education/Training Program | 9031 W Tonopah Dr, Peoria, AZ 85382-6445 | 2019-08-24 |
| 1831751643 | Noreen Khan | Student in an Organized Health Care Education/Training Program | 1501 W Coneflower Dr Apt 2212, Peoria, IL 61615-7465 | 2019-07-01 |
| 1174184527 | Manisha Tharoor | Student in an Organized Health Care Education/Training Program | 530 N.e Glen Oak Ave, Peoria, IL 61637 | 2019-06-26 |
| 1609436724 | Sriviji Senthil Kumaran | Student in an Organized Health Care Education/Training Program | 530. N.e Glen Oak Ave., Peoria, IL 61637 | 2019-06-20 |
| 1780240929 | Abuzar Ali Asif | Student in an Organized Health Care Education/Training Program | 530 N. E. Glen Oak Ave., Peoria, IL 61637 | 2019-05-14 |
| Find all providers in PEORIA | ||||
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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.