SHELLEY PETERSEN (NPI# 1770848152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770848152 |
| Entity Type | Individual |
| Full Name | SHELLEY PETERSEN |
| Practice Address |
138 North Court Street Wampsville NY 13163-0605 |
| Mailing Address |
1640 Middle Rd Oneida NY 13421-4182 |
| Practice Telephone | 3153662363 |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2012-07-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Street Address |
138 NORTH COURT STREET |
| City | WAMPSVILLE |
| State | NY |
| Zip Code | 13163-0605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437196227 | Amintha M. Selvarajah | Physician Assistant | 138 North Court Street, Wampsville, NY 13163-0608 | 2006-06-01 |
| 1003365792 | Stephanie Ann Thompson | Social Worker | 138 North Court Street, Wampsville, NY 13163 | 2016-09-23 |
| 1922495282 | Kathryn Elizabeth Scheirer | Social Worker | 138 North Court Street, Wampsville, NY 13163-0608 | 2015-04-23 |
| 1043603822 | Alexa Brayman | Social Worker | 138 North Court Street, #7, Wampsville, NY 13163 | 2015-03-18 |
| 1750785622 | Kimberly Wallace | Licensed Practical Nurse | 138 North Court Street, Wampsville, NY 13163 | 2014-10-21 |
| 1588905327 | Kirin A Quonce | Social Worker | 138 North Court Street, Veterans Memorial Building, Wampsville, NY 13163 | 2013-03-04 |
| 1700148079 | Lori Brockway | Case Manager/Care Coordinator | 138 North Court Street, Wampsville, NY 13163-0605 | 2012-06-13 |
| 1336428259 | Shannon K Birmingham | Psychologist | 138 North Court Street, Wampsville, NY 13163-0608 | 2011-08-09 |
| 1346542198 | Stephanie Ann Anderson | Social Worker | 138 North Court Street, Wampsville, NY 13163-0608 | 2010-11-30 |
| 1447443437 | Teisha Marie Cook | Social Worker | 138 North Court Street, Wampsville, NY 13163-0608 | 2007-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164824462 | Beth Perry | Social Worker | 138 N Court Street, Wampsville, NY 13163 | 2014-09-18 |
| 1659529949 | Timothy Gerard Brown | Social Worker | 138 N. Court St, Wampsville, NY 13163 | 2008-08-29 |
| 1477752376 | Muftah A. Kadura, Md | Internal Medicine | 235 Genesee St, Wampsville, NY 13163 | 2007-07-12 |
| 1881719888 | Kenneth Edward Hefty | Counselor | 138 North Court Rd, Wampsville, NY 13163 | 2007-03-20 |
| 1518990811 | Denise Michelle Calcagnino | Counselor | Veterans Memorial Building, North Court Street, Wampsville, NY 13163 | 2006-07-09 |
| 1871157065 | Mallory Kleps | Counselor | 138 N Court St, Wampsville, NY 13163 | 2019-04-24 |
| 1861968968 | Mark James Miller | Social Worker | 138 North Court St, Wampsville, NY 13163 | 2018-10-17 |
| 1881194611 | Christina Labella | Counselor | 138 N. Court Street, Wampsville, NY 13163 | 2018-02-19 |
| 1083143358 | Megan Mcpeak | Social Worker | 138 N. Court St., Wampsville, NY 13163 | 2017-06-08 |
| 1568999175 | Madison County Health Deptartment | Case Manager/Care Coordinator | 138 North Court St, Wampsville, NY 13163 | 2017-05-12 |
| Find all providers in zip 13163 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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|---|---|---|---|---|
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| 1619578929 | Ann Marie Spratt | Specialist | 3248 Sentinel Heights Road, Lafayette, NY 13084 | 2020-11-03 |
| 1215538863 | New Era Diagnostics Inc | Specialist | 8815 168th St, Suite 1r, Jamaica, NY 11432-4305 | 2020-11-02 |
| 1699376251 | Ilona Gamer | Specialist | 2525 E 23rd St, Brooklyn, NY 11235-2505 | 2020-11-02 |
| 1891395463 | Mk Star Inc | Specialist | 104 Linwood Ave, Staten Island, NY 10305-4400 | 2020-10-31 |
| 1649870981 | David Abrahams | Specialist | 22016 138th Ave, Laurelton, NY 11413-2325 | 2020-10-27 |
| 1477152122 | Kevin D Spencer | Specialist | 12027 Nashville Blvd Apt 1, Saint Albans, NY 11412-3829 | 2020-10-23 |
| 1356940167 | Jacqueline Belinda Trichter | Specialist | 1400 Old Old Country Rd, Suite C103n, Westbury, NY 11590 | 2020-10-22 |
| Find all providers with the same taxonomy | ||||
| City | WAMPSVILLE |
| Zip Code | 13163 |
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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.