SHANNON JOINT VENTURES, INC (NPI# 1588646392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588646392 |
| Entity Type | Organization |
| Organization Name | SHANNON JOINT VENTURES, INC |
| Other Organization Name | SHANNON DIALYSIS CENTER |
| Practice Address |
2018 Pulliam St San Angelo TX 76905-5148 |
| Mailing Address |
Po Box 22000 San Angelo TX 76902-7200 |
| Practice Telephone | 3256597360 |
| Mailing Telephone | 3256597360 |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2009-12-18 |
| Authorized Official Name | JOHN GILBREATH (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3256581511 |
| Is Organization Subpart | Y |
| Parent Organization Name | SHANNON HEALTH SYSTEMS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
F1646 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 148371102 | 05 |
| Other Name | Type Code |
|---|---|
| SHANNON DIALYSIS CENTER | Doing Business As Name - Organization |
| Street Address |
2018 PULLIAM ST |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76905-5148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508369034 | Greg W Anderson | Nurse Practitioner | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2018-03-12 |
| 1881118693 | Fresenius Kidney Care Concho Valley, LLC | Clinic/Center | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2017-08-02 |
| 1336386028 | Shannon Medical Center | Clinic/Center | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2009-01-16 |
| 1184815342 | Susan C Wilkinson | Clinical Nurse Specialist | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2007-08-05 |
| 1003951245 | David Nichols | Emergency Medicine | 2018 Pulliam St, San Angelo, TX 76905 | 2007-02-21 |
| 1457368367 | Glen Michael Mcferren | Psychiatry & Neurology | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2006-08-02 |
| 1447279351 | Rangarao Chilukuri | Internal Medicine | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2006-07-19 |
| 1710913280 | Jackson Todd Achilles | Psychiatry & Neurology | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2006-06-24 |
| 1235199084 | Shannon Medical Center | Psychiatric Unit | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2006-03-24 |
| 1114987963 | Shannon Medical Center | Skilled Nursing Facility | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2006-03-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639437197 | Richard Yeaton Burnell | Registered Nurse | 2018 Bus Us Highway 67-j, San Angelo, TX 76905 | 2012-05-02 |
| 1568752053 | Lucy Jo Smith | Counselor | 2710 Smith Blvd., San Angelo, TX 76905 | 2011-04-18 |
| 1821204587 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 2706 Watson Street, San Angelo, TX 76905 | 2007-05-16 |
| 1770688103 | Alan Keith Carson | Counselor | 218 Pulliam St., San Angelo, TX 76905 | 2006-09-13 |
| 1851992515 | Stacie A Gregg | Nurse Practitioner | 1229 Johnny Ln, San Angelo, TX 76905-2331 | 2020-11-07 |
| 1417340910 | Leslie Ann Rendon | Contractor | 1213 Rita Cir, San Angelo, TX 76905-4201 | 2015-03-09 |
| 1972925295 | Carlos Robledo | Pharmacist | 2626 Smith Blvd, San Angelo, TX 76905-4285 | 2014-01-07 |
| 1376163501 | Megan Elizabeth Barnum | Registered Nurse | 1231 Rita Cir, San Angelo, TX 76905-4292 | 2020-04-17 |
| 1225031446 | Shannon Medical Center | Home Health | 2030 Pulliam St, Ste 6, San Angelo, TX 76905-5157 | 2005-05-23 |
| 1285845214 | Shannon Health Sys Pharmacy Pap | Pharmacy | 2030 Pulliam St Ste 16, San Angelo, TX 76905-5170 | 2007-05-24 |
| Find all providers in zip 76905 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447494562 | Angelo Nephrology Associated | Internal Medicine | 18 W College Ave, San Angelo, TX 76903-5814 | 2009-04-21 |
| 1194960708 | Adc Inc | Internal Medicine | 7573 El Camino Grande, San Angelo, TX 76904-4720 | 2008-12-10 |
| 1205820966 | John A Stevenson | Internal Medicine | 210 E Harris Ave, San Angelo, TX 76903-5906 | 2005-09-08 |
| 1376548008 | West Texas Nephrology Associates | Internal Medicine | 136 E Concho Ave, San Angelo, TX 76903-5947 | 2005-06-17 |
| 1013912740 | Jesse L Jurado | Internal Medicine | 3501 Executive Dr, San Angelo, TX 76904-6883 | 2005-06-17 |
| 1255696522 | Melissa Aleta | Internal Medicine | 220 E. Harris, San Angelo, TX 76903 | 2012-07-11 |
| 1225397250 | Kaushal Sondarwa | Internal Medicine | 220 E. Harris, San Angelo, TX 76903 | 2012-05-11 |
| 1184881625 | Amin Parhizgar | Internal Medicine | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2008-05-21 |
| 1922280882 | West Texas Nephrology Associates | Internal Medicine | 3501 Executive Dr, San Angelo, TX 76904-6883 | 2007-12-03 |
| 1699770313 | Steve Frank Montoya Jr. | Internal Medicine | 136 E Concho Ave, San Angelo, TX 76903-5947 | 2005-06-17 |
| Find all providers in SAN ANGELO | ||||
| City | SAN ANGELO |
| Zip Code | 76905 |
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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.