MS. SHANNON BLUME-KESSELRING (NPI# 1700893914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700893914 |
| Entity Type | Individual |
| Full Name | MS. SHANNON BLUME-KESSELRING |
| Credential | NP |
| Practice Address |
750 E Adams St Syracuse NY 13210-2306 |
| Mailing Address |
208 Jamesville Road Dewitt NY 13214 |
| Practice Telephone | 3154645450 |
| Mailing Telephone | 3154490058 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2008-05-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0200X |
Registered Nurse Specialization: Pediatrics |
4918541 | NY | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
F333382 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02254557 | 05 | |
| NY | 02873201 | 05 |
| Street Address |
750 E ADAMS ST |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13210-2306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922003193 | Aqeel A Sandhu | Specialist | 750 E Adams St, Syracuse, NY 13210-2306 | 2005-06-15 |
| 1770183972 | Subhashree Dasgupta | Speech-Language Pathologist | 750 E Adams St, Syracuse, NY 13210-1834 | 2020-10-27 |
| 1841890118 | Danielle Coniglio Gonzalez | Physical Medicine & Rehabilitation | 750 E Adams St, Syracuse, NY 13210-2306 | 2020-10-27 |
| 1497353858 | Kayleigh M Gifford | Nurse Practitioner | 750 E Adams St, Syracuse, NY 13210-1834 | 2020-10-16 |
| 1578160891 | Steven Lounsbury | Physical Therapist | 750 E Adams St, Syracuse, NY 13210-2306 | 2020-10-09 |
| 1306453295 | Sarah Persons | Nurse Practitioner | 750 E Adams St, Syracuse, NY 13210-1834 | 2020-09-25 |
| 1356956270 | Carlo Manalo Dangcalan | Student in an Organized Health Care Education/Training Program | 750 E Adams St, Syracuse, NY 13210-2306 | 2020-09-09 |
| 1104430396 | Rida Sherwani | Student in an Organized Health Care Education/Training Program | 750 E Adams St, Syracuse, NY 13210-2306 | 2020-09-03 |
| 1003420803 | Michel Tawil | Student in an Organized Health Care Education/Training Program | 750 E Adams St, Syracuse, NY 13210-2306 | 2020-08-31 |
| 1669085056 | Komal Syeda | Nurse Practitioner | 750 E Adams St, Syracuse, NY 13210-1834 | 2020-08-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558973586 | Maizie Marie Shaw | Social Worker | 660 Madison Street, Syracuse, NY 13210 | 2020-08-20 |
| 1427666916 | Christine Marie Welker | Registered Nurse | 735 Irving Avenue, Syracuse, NY 13210 | 2020-07-21 |
| 1386263994 | Ashwini Krishna Ashwath | Student in an Organized Health Care Education/Training Program | 750 E. Adams Street, Syracuse, Ny 13210, Syracuse, NY 13210 | 2020-04-14 |
| 1073142329 | Kamala Ojha | Student in an Organized Health Care Education/Training Program | 750-east Adam's Street, Syracuse, NY 13210 | 2020-04-07 |
| 1003442369 | Brittany Nicole Lippert | Counselor | 615 Madison St, Syracuse, NY 13210 | 2020-03-19 |
| 1902430499 | Dkt Physician Pllc | Internal Medicine | 475 Irving Ave, Suite 410, Syracuse, NY 13210 | 2020-02-24 |
| 1376194720 | Sarah Van Eenenaam | Physician Assistant | Adult Cardiac Surgery, 750 East Adams St, Syracuse, NY 13210 | 2019-09-26 |
| 1265099022 | Michelle Gallagher | Psychologist | Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210 | 2019-05-28 |
| 1639659428 | Francesca Wanda Cotrupe | Physical Medicine & Rehabilitation | Upstate Medical University Hospital, 750 E Adams Street, Syracuse, NY 13210 | 2018-08-21 |
| 1700370327 | Dallin Lindahl | Physical Medicine & Rehabilitation | 750 E Adams St # Jh308, Syracuse, NY 13210 | 2018-06-18 |
| Find all providers in zip 13210 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410186 | Katie Elise Boyd | Nurse Practitioner | 725 Irving Ave Ste 504, Syracuse, NY 13210-1683 | 2020-09-03 |
| 1023633427 | Katherine Ellen Smith | Nurse Practitioner | 736 Irving Ave # 9100, Syracuse, NY 13210-1687 | 2020-06-11 |
| 1053575829 | Tashika Gomez | Nurse Practitioner | 428 S Alvord St, Syracuse, NY 13208-2720 | 2008-07-10 |
| 1114180015 | Tracey Jo Rheaume | Nurse Practitioner | 725 Irving Avenue Suite 112, Center for Neurodevelopmemtl Pediatrics Crouse Pob, Syracuse, NY 13210-1624 | 2008-07-10 |
| 1538264312 | Nancy P Mitchell | Nurse Practitioner | 90 Presidential Plz Fl 3, University Pediatric and Adolescent Center, Syracuse, NY 13202-2240 | 2006-09-14 |
| 1821616962 | Brittney Johnson | Nurse Practitioner | 736 Irving Ave Ste 9100, Syracuse, NY 13210-1687 | 2020-07-06 |
| 1114542511 | Heather N Bedard | Nurse Practitioner | 736 Irving Ave, Syracuse, NY 13210-1687 | 2020-06-11 |
| 1841858370 | Heather Pitts | Nurse Practitioner | 819 S Salina St, Syracuse, NY 13202-3570 | 2019-05-30 |
| 1922572379 | Kristen Marie Maas | Nurse Practitioner | 750 E Adams St, Syracuse, NY 13210-2306 | 2019-01-18 |
| 1225518707 | Erica Kendrew | Nurse Practitioner | 819 S Salina St, Syracuse, NY 13202 | 2018-08-15 |
| Find all providers in SYRACUSE | ||||
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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.