SHAYNA SHACKFORD (NPI# 1609281567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609281567 |
| Entity Type | Individual |
| Full Name | SHAYNA SHACKFORD |
| Credential | DO |
| Practice Address |
824 Illinois Ave Stevens Point WI 54481 |
| Mailing Address |
824 Illinois Ave Stevens Point WI 54481-3112 |
| Practice Telephone | 7153465000 |
| Mailing Telephone | 7153465000 |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2018-08-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | TP14078 | ME | Allopathic & Osteopathic Physicians |
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
69714 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
824 ILLINOIS AVE |
| City | STEVENS POINT |
| State | WI |
| Zip Code | 54481 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528053626 | Lynn B Kohlmeier | Pediatrics | 824 Illinois Ave, Stevens Point, WI 54481-3112 | 2005-09-14 |
| 1427618487 | Alicia Wojtalewicz | Nurse Practitioner | 824 Illinois Ave, Stevens Point, WI 54481-3112 | 2019-06-20 |
| 1487212486 | Ascension St Michael's Hospital, Inc | Technician/Technologist | 824 Illinois Ave, Stevens Point, WI 54481-3112 | 2019-06-04 |
| 1275090169 | Michelle Whitehouse | Nurse Practitioner | 824 Illinois Ave, Stevens Point, WI 54481-3112 | 2019-02-27 |
| 1326524919 | Marie Beranek | Nurse Practitioner | 824 Illinois Ave, Stevens Point, WI 54481-3112 | 2018-07-17 |
| 1629570890 | Lori Lenhard | Counselor | 824 Illinois Ave, Stevens Point, WI 54481-3112 | 2018-03-05 |
| 1013454164 | Dessia J Laxton-reinke | Nurse Practitioner | 824 Illinois Ave, Stevens Point, WI 54481-3112 | 2017-01-27 |
| 1225570633 | Jacquelyn D Nichols | Physician Assistant | 824 Illinois Ave, Stevens Point, WI 54481-3112 | 2016-11-16 |
| 1770987299 | Kali Southworth | Physician Assistant | 824 Illinois Ave, Stevens Point, WI 54481-3112 | 2014-10-13 |
| 1689091233 | Joelle Frank | Dietitian, Registered | 824 Illinois Ave, Stevens Point, WI 54481-3112 | 2014-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790309649 | County of Portage | Clinic/Center | 1519 Water Street, Stevens Point, WI 54481 | 2020-06-05 |
| 1700400736 | Sarai Sophia Holbrook | Speech-Language Pathologist | Room 038 Cps, 1901 Fourth Ave., Uw-stevens Point, Stevens Point, WI 54481 | 2020-06-05 |
| 1164994117 | Copperleaf Home Health Inc | Homemaker | 1077 Wilshire Blvd, Stevens Point, WI 54481 | 2018-12-31 |
| 1568980274 | Melissa Jean Gutierrez | Dental Hygienist | 941 Michigan Ave, Stevens Point, WI 54481 | 2017-09-01 |
| 1164946026 | Brittany Rose Larocque | Chiropractor | 3908 Green Ct, Stevens Point, WI 54481 | 2017-08-01 |
| 1245750009 | Alyssa Kate Koth | Speech-Language Pathologist | Rm 038 Cps 1901 Fourth Ave, Unviersity of Wisconsin-stevens Point, Stevens Point, WI 54481 | 2017-06-22 |
| 1881133734 | Teri Jean Edlebeck | Specialist/Technologist | 1017 Williams Street, Stevens Point, WI 54481 | 2017-02-13 |
| 1215475892 | Valerie Lynn Fons | Dental Hygienist | 941 Michigan Avenue, Stevens Point, WI 54481 | 2017-02-03 |
| 1427509439 | Tanner Ozanne | Chiropractor | 2212 Division St, Stevens Point, WI 54481 | 2016-10-14 |
| 1134594765 | Dana Fredrickson | Registered Nurse | 616 Franklin St, Stevens Point, WI 54481 | 2015-12-08 |
| Find all providers in zip 54481 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| 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 Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710486121 | Integrity Senior Health | Family Medicine | 4347 Danbury Ln, Mount Pleasant, WI 53403-4022 | 2018-02-12 |
| 1508075409 | Jonny Alexander Macias Tejada | Family Medicine | 1020 N 12th St Ste 301, Milwaukee, WI 53233-1308 | 2007-05-21 |
| 1902907454 | Michael Lee Douglas | Family Medicine | 1110 Bergslien Street, Baldwin, WI 54002 | 2006-09-26 |
| 1801888938 | Mary C Ball | Family Medicine | 100 Silverado Dr, Stoughton, WI 53589-5406 | 2005-08-16 |
| 1790312171 | Sequoia Integrative Medical Services LLC | Family Medicine | 1351 Ontario Rd, Green Bay, WI 54311-8302 | 2020-03-25 |
| 1275174922 | Leslie Ann Las | Family Medicine | 500 East Veterans Street, Tomah, WI 54660 | 2019-10-03 |
| 1558795914 | Richard London, M.d., L.L.C. | Family Medicine | 5000 W Chambers St, Milwaukee, WI 53210-1650 | 2013-08-21 |
| 1255518437 | Galia Paganelli | Family Medicine | 800 West Ave S, La Crosse, WI 54601-8806 | 2008-01-30 |
| 1235349077 | Ellen Turner Wenberg | Family Medicine | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2007-05-23 |
| 1295952208 | Michael Stephen Garrity | Family Medicine | 916 Ferry St, La Crosse, WI 54601-4717 | 2007-04-19 |
| Find all providers with the same taxonomy | ||||
| City | STEVENS POINT |
| Zip Code | 54481 |
Please comment or provide details below to improve the information on SHAYNA SHACKFORD.
| 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.