DR. MARK S. SHOCKLEY (NPI# 1831146042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831146042 |
| Entity Type | Individual |
| Full Name | DR. MARK S. SHOCKLEY |
| Credential | M.D. |
| Practice Address |
2710 Saint Francis Dr Suite 410 Waterloo IA 50702-5619 |
| Mailing Address |
2101 Kimball Ave Ll14 Waterloo IA 50702-5063 |
| Practice Telephone | 3192725000 |
| Practice Fax Number | 3192725264 |
| Mailing Telephone | 3192721590 |
| Mailing Fax Number | 3192721535 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2007-07-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | 34175 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0249706 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437140365 | Mark Edward Shockley | Anesthesiology | 3700 Washington Ave, Evansville, IN 47714-0541 | 2005-10-31 |
| Street Address |
2710 SAINT FRANCIS DR SUITE 410 |
| City | WATERLOO |
| State | IA |
| Zip Code | 50702-5619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639166390 | Lisa M Coleman | Dietitian, Registered | 2710 Saint Francis Dr, Suite 510, Waterloo, IA 50702-5619 | 2005-09-28 |
| 1003303165 | Summer Morgan Lenth | Nurse Practitioner | 2710 Saint Francis Dr, Waterloo, IA 50702-5619 | 2018-04-15 |
| 1033621586 | Hilary Pates | Counselor | 2710 Saint Francis Dr, Waterloo, IA 50702-5619 | 2017-10-24 |
| 1447676812 | Katherine Renner | Pharmacist | 2710 Saint Francis Dr, Suite 510, Waterloo, IA 50702-5619 | 2014-03-10 |
| 1649611567 | Toni Lynn Luck | Nurse Practitioner | 2710 Saint Francis Dr, Suite 319, Waterloo, IA 50702-5619 | 2013-07-08 |
| 1275809584 | Marietta Elizabeth Walsh | Neurological Surgery | 2710 Saint Francis Dr, Suite 110, Waterloo, IA 50702-5619 | 2012-03-30 |
| 1902174584 | Northland Hearing Centers, Inc. | Audiologist-Hearing Aid Fitter | 2710 Saint Francis Dr, #411, Waterloo, IA 50702-5619 | 2011-12-09 |
| 1851671192 | Melissa Ann Groeneveld | Nurse Practitioner | 2710 Saint Francis Dr, Suite 419, Waterloo, IA 50702-5619 | 2011-08-18 |
| 1336428697 | Victor Adam Abrich | Internal Medicine | 2710 Saint Francis Dr, Ste 320, Waterloo, IA 50702-5620 | 2011-08-04 |
| 1821301649 | Kristin Marie Davis | Nurse Practitioner | 2710 Saint Francis Dr, Ste 111, Waterloo, IA 50702-5619 | 2010-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684709 | Peoples Community Health Clinic, Inc | Clinic/Center | 425 1/2 East Ridgeway Ave., Waterloo, IA 50702 | 2020-09-23 |
| 1346867439 | Kinza Ali | Family Medicine | 2055 Kimball Avenue, Suite 101, Waterloo, IA 50702 | 2020-07-06 |
| 1073176533 | Sandeep Badyal | Family Medicine | Ne Ia Family Medicine Residency Program, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-19 |
| 1619530763 | Sophia Tariq Qureshi | Family Medicine | Ne Ia Medical Education Foundation, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-15 |
| 1659869915 | Alicia M Johnson | Advanced Practice Midwife | 439 King Street, Waterloo, IA 50702 | 2018-04-23 |
| 1427591411 | Alexandra E. Becker | Specialist/Technologist | 4157 Mourning Dove Drive, Waterloo, IA 50702 | 2016-11-23 |
| 1255793196 | Eastern Iowa Therapeutics PC | Physical Therapist | 1655 E San Marnan Dr, Ste A, Waterloo, IA 50702 | 2016-03-21 |
| 1972859288 | Noble Cedar Psychological Institute | Psychologist | 1425 W. 5th Street, Suite 1, Waterloo, IA 50702 | 2012-07-24 |
| 1417223363 | Rita Marie Menart | Counselor | 2101 Kimball Ave., Suite 138, Waterloo, IA 50702 | 2012-03-26 |
| 1336411685 | Jagpal Singh Suman | Hospitalist | 3421 West 9th Street, Waterloo, IA 50702 | 2012-02-02 |
| Find all providers in zip 50702 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245541663 | Anna Wahlig | Anesthesiology | 703 Lakeview Dr, Waterloo, IL 62298-1847 | 2010-06-30 |
| 1245661560 | Resolute Anesthesia Illinois Sc | Anesthesiology | 501 Hamacher St, Waterloo, IL 62298-1568 | 2013-12-12 |
| 1275970352 | Joshua Priebe | Anesthesiology | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2013-05-29 |
| 1093159642 | Rachelle Alexandra Makinde | Anesthesiology | 3421 W 9th St, Waterloo, IA 50702-5401 | 2013-04-25 |
| 1538423231 | Andrew Tim Shen | Anesthesiology | 3421 W 9th St, Waterloo, IA 50702-5401 | 2012-06-27 |
| 1417238759 | Liang Zhang | Anesthesiology | 3421 W 9th St, Covenant Medical Center, Wheaton Franciscan Healthcare, Waterloo, IA 50702-5401 | 2011-08-31 |
| 1285929653 | Shamas Chungez Kiani | Anesthesiology | 1825 Logan Ave, Waterloo, IA 50703 | 2011-06-14 |
| 1083852248 | Vijayasimha Reddy Pothula | Anesthesiology | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2009-01-27 |
| 1417168667 | Albert Jerome Jackson Jr. | Anesthesiology | 2710 Saint Francis Dr, Ste 410, Waterloo, IA 50702-5619 | 2007-05-26 |
| 1982813739 | Matthew J Grady | Anesthesiology | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2007-05-21 |
| Find all providers in WATERLOO | ||||
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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.