DR. SHANNON GAMMILL BERRY (NPI# 1770719668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770719668 |
| Entity Type | Individual |
| Full Name | DR. SHANNON GAMMILL BERRY |
| Other Name | SHANNON GAMMILL SMITH |
| Credential | M.D. |
| Practice Address |
1635 Marvel St Coushatta LA 71019-9022 |
| Practice Telephone | 3189322000 |
| Mailing Telephone | 3189322000 |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2016-10-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 208173 | LA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | P1727 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2400894 | 05 | |
| LA | RAILROAD MEDICARE PTAN | P01575286 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720401714 | Shannon D. Berry | Speech-Language Pathologist | 1231 Harbor River Dr, Memphis, TN 38103-8980 | 2014-01-27 |
| 1922141555 | Shannon Lee Jett Berry | Speech-Language Pathologist | 218 N Florida St, Suite 3, Bushnell, FL 33513-6150 | 2007-02-14 |
| 1679174643 | Shannon Berry | Pharmacist | 1712 E Ohio St, Clinton, MO 64735-2402 | 2020-11-05 |
| 1205253267 | Shannon Berry | Emergency Medicine | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2014-03-27 |
| 1295057818 | Shannon Berry | Occupational Therapy Assistant | 420 Gaffney Dr, Watertown, NY 13601-1823 | 2010-02-23 |
| 1649381245 | Shannon Berry | Advanced Practice Midwife | 100 Brewster Blvd, Medical Staff Services, Camp Lejeune, NC 28547-2538 | 2006-08-31 |
| 1013909811 | Shannon M Berry | Internal Medicine | 295 Posada Ln, Suite D, Templeton, CA 93465-4055 | 2005-08-17 |
| Street Address |
1635 MARVEL ST |
| City | COUSHATTA |
| State | LA |
| Zip Code | 71019-9022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326043753 | Lavora Chevon Babers-wilson | Nurse Practitioner | 1635 Marvel St, Coushatta, LA 71019 | 2005-06-13 |
| 1013575695 | J.l. Nurse Practitioner, LLC | Nurse Practitioner | 1635 Marvel St, Coushatta, LA 71019-9022 | 2019-05-30 |
| 1982177556 | Jennifer L Perry | Nurse Practitioner | 1635 Marvel St, Coushatta, LA 71019-9022 | 2019-01-07 |
| 1417494758 | Christus Health Central Louisiana | Emergency Medicine | 1635 Marvel St, Coushatta, LA 71019-9022 | 2017-01-25 |
| 1003365636 | Christopher Troy Bamburg | Physician Assistant | 1635 Marvel St, Coushatta, LA 71019-9022 | 2016-09-23 |
| 1073069589 | Misti Lelong Morgan | Nurse Practitioner | 1635 Marvel St, Coushatta, LA 71019-9022 | 2016-08-26 |
| 1427480680 | Coushatta Er Physicians | Emergency Medicine | 1635 Marvel St, Coushatta, LA 71019-9022 | 2013-07-30 |
| 1245466408 | Joshua Ray Cason | Emergency Medicine | 1635 Marvel St, Coushatta, LA 71019-9022 | 2009-06-02 |
| 1689817512 | Western La Emergency Physicians | Emergency Medicine | 1635 Marvel St, Coushatta, LA 71019-9022 | 2009-04-08 |
| 1568643674 | Sheila M Woodard | Registered Nurse | 1635 Marvel St, Coushatta, LA 71019-9022 | 2007-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255898763 | Saint Mark Hospice and Palliative Care LLC | Hospice Care, Community Based | Saint Mark Hospice and Palliative Care LLC, 298 Army Rd, Coushatta, LA 71019 | 2019-02-21 |
| 1750824900 | Ruby Braxton | Counselor | 936 E. Carroll Street, Coushatta, LA 71019 | 2016-11-21 |
| 1447621222 | Ranette Smith | Counselor | 1414 Leigh Street, Coushatta, LA 71019 | 2015-10-19 |
| 1205157237 | Red River Parish Police Jury | Ambulance | 525 Rush Street, Coushatta, LA 71019 | 2010-06-14 |
| 1255566857 | Medcore Specialty Pharmacy | Pharmacy | 1435 E. Carroll St., Suite B, Coushatta, LA 71019 | 2009-05-27 |
| 1437346186 | Specialty Rehabilitation Hospital, L.L.C. | Rehabilitation Hospital | 1110 Ringgold Avenue, Suite B, Coushatta, LA 71019 | 2007-09-26 |
| 1679785976 | Red River Council On Aging, Inc. | Adult Companion | 1825 Front Street, Coushatta, LA 71019 | 2007-05-07 |
| 1699805515 | Red River Association for Retarded Citizens Inc | Day Training, Developmentally Disabled Services | 1908 Hwy 71 S, Coushatta, LA 71019 | 2007-03-07 |
| 1629108386 | Red River Association for Retarded Citizens Inc | Day Training, Developmentally Disabled Services | 1908 Hwy 71 South, Coushatta, LA 71019 | 2007-03-06 |
| 1245366251 | The Will of God Ministries Outreach Program | Preferred Provider Organization | 1113 Caliope Street, Coushatta, LA 71019 | 2007-02-26 |
| Find all providers in zip 71019 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710984513 | Wyche Taylor Coleman Jr. | Emergency Medicine | 1633 Marvel St, Coushatta, LA 71019-9022 | 2005-07-07 |
| 1417494758 | Christus Health Central Louisiana | Emergency Medicine | 1635 Marvel St, Coushatta, LA 71019-9022 | 2017-01-25 |
| 1427480680 | Coushatta Er Physicians | Emergency Medicine | 1635 Marvel St, Coushatta, LA 71019-9022 | 2013-07-30 |
| 1245466408 | Joshua Ray Cason | Emergency Medicine | 1635 Marvel St, Coushatta, LA 71019-9022 | 2009-06-02 |
| 1689817512 | Western La Emergency Physicians | Emergency Medicine | 1635 Marvel St, Coushatta, LA 71019-9022 | 2009-04-08 |
| 1487865937 | Martin John Carter | Emergency Medicine | 1633 Marvel St, Coushatta, LA 71019-9022 | 2007-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346848538 | Samire Almeida De Oliveira | Emergency Medicine | 701 Poydras St Suite 104, New Orleans, LA 70139 | 2020-10-11 |
| 1467094268 | Executive Medicine, LLC | Emergency Medicine | 701 Poydras St Ste 104, New Orleans, LA 70139-7761 | 2019-10-13 |
| 1750858387 | Prairieville General Hospital, LLC | Emergency Medicine | 37358 Market Place Drive, Prairieville, LA 70769 | 2018-11-01 |
| 1164956827 | Occucare International Lafayette | Emergency Medicine | 1028 Forum Dr, Broussard, LA 70518-8060 | 2017-04-19 |
| 1831544535 | Joseph Gallien | Emergency Medicine | 3418 Truman St, Lake Charles, LA 70607-2114 | 2016-04-30 |
| 1639533755 | Elizabeth Hays Boyle Cassels | Emergency Medicine | 4256 Brittany Drive, Baton Rouge, LA 70808 | 2016-04-06 |
| 1194119289 | Ryan Christopher Jupiter | Emergency Medicine | 1441 N Miro St, New Orleans, LA 70119-2618 | 2015-03-26 |
| 1528452802 | Julia Terle | Emergency Medicine | 5025 S Prieur St, New Orleans, LA 70125-4946 | 2015-03-24 |
| 1134549322 | Marc Fernandez | Emergency Medicine | 121 Rue Louis Xiv Bldg 5, Lafayette, LA 70508-5786 | 2014-04-26 |
| 1235559055 | Bridgette Celeste Egan | Emergency Medicine | 2331 Lapeyrouse St, New Orleans, LA 70119-2521 | 2014-04-19 |
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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.