DR. SHANNON R. JIMENEZ (NPI# 1568552628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568552628 |
| Entity Type | Individual |
| Full Name | DR. SHANNON R. JIMENEZ |
| Credential | D.O. |
| Practice Address |
2600 Us Highway 70 West Goldsboro NC 27530 |
| Mailing Address |
690 S Loop 336 W Ste 200 Conroe TX 77304-3320 |
| Practice Telephone | 9197352478 |
| Practice Fax Number | 9197394809 |
| Mailing Telephone | 9365253600 |
| Mailing Fax Number | 9365253624 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-03-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 9900553 | IA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | S4847 | TX | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 9900553 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 891215K | 05 | |
| NC | 790150C | 05 | |
| NC | BLUE CROSS INDIVIDUAL | 1215K | 01 |
| NC | BLUE CROSS GROUP # | 0150C | 01 |
| Street Address |
2600 US HIGHWAY 70 WEST |
| City | GOLDSBORO |
| State | NC |
| Zip Code | 27530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831689777 | A Fathers' Love Family Care Inc | Home Health | 213 N. Carolina St., Goldsboro, NC 27530 | 2018-05-16 |
| 1609274687 | Tiffany Leanne Farmer | Counselor | 1184 Us Hwy 13 South, Goldsboro, NC 27530 | 2014-12-08 |
| 1316369952 | Angela Brittingham | Counselor | 113 Sanderling Way, Goldsboro, NC 27530 | 2014-01-16 |
| 1831408996 | At Home Senior Services, Inc. | Home Health | 203 N. Jackson Street Office C, Goldsboro, NC 27530 | 2010-10-06 |
| 1699946301 | Professional Group Living,llc | Community/Behavioral Health | 122 S. Center Street, Goldsboro, NC 27530 | 2008-03-20 |
| 1225250814 | Asa Living, Inc | Clinic/Center | 1308 Ben Brewington Court, Goldsboro, NC 27530 | 2007-05-03 |
| 1790907368 | Tammy Jo Hood | Licensed Practical Nurse | 1700 East Ash Street St. 200, Goldsboro, NC 27530 | 2007-05-03 |
| 1558487421 | Alternative Care Treatments Systems, Inc | Community/Behavioral Health | 139-b Center Street, Goldsboro, NC 27530 | 2007-03-22 |
| 1831221050 | Matthew Gay Delbridge | Dentist | 206 West Ash St, Goldsboro, NC 27530 | 2007-03-12 |
| 1508998295 | Emeritus Corporation | Assisted Living Facility | 380 County Day Road, Goldsboro, NC 27530 | 2007-03-09 |
| Find all providers in zip 27530 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164769709 | Rosewood Medical | Family Medicine | 172 Nc Highway 581 S, Goldsboro, NC 27530-9404 | 2013-01-15 |
| 1952670838 | Rosewood Immediate Care | Family Medicine | 172 Us Highway 581 South, Goldsboro, NC 27530-9404 | 2011-12-21 |
| 1467619817 | Little River Med 1 Pa | Family Medicine | 210 N Herman St, Goldsboro, NC 27530-3810 | 2008-05-21 |
| 1588840417 | Felicia D. Hussey, M.d., P.a. | Family Medicine | 327 N Spence Ave, Goldsboro, NC 27534-4347 | 2008-01-10 |
| 1407908148 | Felicia D Hussey | Family Medicine | 327 North Spence Avenue, Goldsboro, NC 27534-4347 | 2007-01-16 |
| 1184706830 | Ellen Brubeck Brogden | Family Medicine | 1509 E Ash St, Goldsboro, NC 27530 | 2006-10-20 |
| 1225118839 | John Scott Mcconnaughey | Family Medicine | 400 Old Smithfield Rd, Goldsboro, NC 27530-8464 | 2006-10-17 |
| 1871681478 | Anthony Clark Gaither | Family Medicine | 2607 Medical Office Pl, Goldsboro, NC 27534-9437 | 2006-10-10 |
| 1578662144 | Robert S. Meyer | Family Medicine | 208 N Herman St, Goldsboro, NC 27530-3810 | 2006-09-21 |
| 1720198070 | Tin Trong Le | Family Medicine | 1707 Wayne Memorial Dr, Goldsboro, NC 27534-2239 | 2006-08-30 |
| Find all providers in GOLDSBORO | ||||
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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.