SHANNON BOLDENOW (NPI# 1720628357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720628357 |
| Entity Type | Individual |
| Full Name | SHANNON BOLDENOW |
| Practice Address |
44405 Woodward Ave Pontiac MI 48341-5023 |
| Mailing Address |
4840 Alton Ct Troy MI 48085-5044 |
| Practice Telephone | 2488583000 |
| Enumeration Date | 2020-01-12 |
| Last Update Date | 2020-01-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 4704283091 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
44405 WOODWARD AVE |
| City | PONTIAC |
| State | MI |
| Zip Code | 48341-5023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871598433 | Nicola Lynn Juzysta | Pharmacist | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2005-06-20 |
| 1598364911 | Briahnnon Long | Nurse Practitioner | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2020-10-19 |
| 1831705060 | Christopher Lopez | Emergency Medical Technician, Paramedic | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2020-09-22 |
| 1124645627 | Vikram Aiman Ayapati | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave, Pontiac, MI 48341 | 2020-06-30 |
| 1457978280 | Dilnaz Alam | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2020-06-27 |
| 1700402807 | Peter De Mola | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2020-06-24 |
| 1093331241 | Paul Young Mah | Anesthesiology | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2020-06-23 |
| 1205452430 | Ali Khan | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2020-06-23 |
| 1326664624 | Brandon Christopher Merta | Registered Nurse | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2020-06-22 |
| 1154946051 | Molly Elizabeth Dwenger | Dentist | 44405 Woodward Ave, Medical Eduation - H23, Pontiac, MI 48341-5023 | 2020-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003415837 | Brittany Taylor Shandor | Registered Nurse | 32 East, 1200 Telegraph Rd, Pontiac, MI 48341 | 2020-10-22 |
| 1013534999 | Siddharth Chopra | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue Saint Joseph Mercy Oakland Hospit, Medical Education H-23, Pontiac, MI 48341 | 2020-06-26 |
| 1972120962 | Tara Elizabeth Bjorklund | Obstetrics & Gynecology | 44405 Woodward Ave - H23, St. Joseph Mercy Oakland - Gme Office, Pontiac, MI 48341 | 2020-06-25 |
| 1245856145 | Sarah Fatima | Student in an Organized Health Care Education/Training Program | St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-17 |
| 1407471188 | Tyler Schaefer | Emergency Medical Technician, Basic | 32east 1200 N. Telegraph Rd., Pontiac, MI 48341 | 2020-06-09 |
| 1639793581 | Yash Kirankumar Varma | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-05 |
| 1326661687 | Fnu Kavita | Student in an Organized Health Care Education/Training Program | C/o Shelly Casey, St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue Medical Education - H23, Pontiac, MI 48341 | 2020-05-21 |
| 1801452578 | Lolita Curry | Registered Nurse | 32 East 1200 Telegraph, Pontiac, MI 48341 | 2019-05-17 |
| 1619530060 | Priyadarshini Dixit | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, St. Joseph Mercy Oakland Hospita, Pontiac, MI 48341 | 2019-04-20 |
| 1891358370 | Anil Gurpersaud | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave., St. Joseph Mercy Oakland, Pontiac, MI 48341 | 2019-04-19 |
| Find all providers in zip 48341 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699715508 | Kevin M Daymon | Nurse Anesthetist, Certified Registered | 50 North Perry, Pontiac, MI 48342 | 2006-06-08 |
| 1679111603 | Rachel Potestato | Nurse Anesthetist, Certified Registered | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2019-12-20 |
| 1275171480 | Taylor Moran | Nurse Anesthetist, Certified Registered | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2019-12-18 |
| 1447737952 | Michael John Knapp | Nurse Anesthetist, Certified Registered | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2018-07-26 |
| 1366981656 | Eric Paul Jahn | Nurse Anesthetist, Certified Registered | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2017-02-20 |
| 1972940062 | Melissa Konopka | Nurse Anesthetist, Certified Registered | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2013-05-29 |
| 1700188026 | Sheila R. Williamson | Nurse Anesthetist, Certified Registered | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2010-11-18 |
| 1528369444 | Sara E. Hussin | Nurse Anesthetist, Certified Registered | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2010-11-09 |
| 1073823803 | Lindsey Sarnovsky | Nurse Anesthetist, Certified Registered | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2010-10-14 |
| 1487983714 | Heather Dawn Nykiel | Nurse Anesthetist, Certified Registered | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2009-12-16 |
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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.