MS. SHANNON PACKER (NPI# 1861825259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861825259 |
| Entity Type | Individual |
| Full Name | MS. SHANNON PACKER |
| Credential | PA-C |
| Practice Address |
28 Crescent St Middletown CT 06457-3654 |
| Practice Telephone | 8602682879 |
| Mailing Telephone | 8602682879 |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2019-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2946 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
23.002946 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
28 CRESCENT ST |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-3654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790788859 | Eric B Neadel | Physician Assistant | 28 Crescent St, Middletown, CT 06457-3654 | 2005-05-23 |
| 1861001729 | Adrianne Lynn Wyckoff | Registered Nurse | 28 Crescent St, Middletown, CT 06457-3650 | 2020-07-27 |
| 1639791577 | Peder Johnsen | Nurse Practitioner | 28 Crescent St, Middletown, CT 06457-3654 | 2020-05-14 |
| 1275171530 | Lisa Ann Tringali | Recreation Therapist | 28 Crescent St, Middletown, CT 06457-3654 | 2019-12-18 |
| 1528600160 | Antonella Rosa Sferrazza | Counselor | 28 Crescent St, Middletown, CT 06457-3654 | 2019-10-15 |
| 1548801830 | Michael Tammaro | Physician Assistant | 28 Crescent St, Middletown, CT 06457-3654 | 2019-10-08 |
| 1699240705 | Mary Theresa Doyle | Social Worker | 28 Crescent St, Middletown, CT 06457-3650 | 2018-10-05 |
| 1649761040 | Emily Eklof | Nurse Practitioner | 28 Crescent St, Middletown, CT 06457 | 2018-05-22 |
| 1285141077 | Christine O'grady | Social Worker | 28 Crescent St, Middletown, CT 06457-3654 | 2018-01-03 |
| 1871022293 | Jacqueline Mary Atkinson | Physician Assistant | 28 Crescent St, Middletown, CT 06457-3654 | 2017-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235738006 | Amanda Kwartemaah Osei | Physician Assistant | 2 Colonial Sq, Middletown, NJ 07748-3548 | 2020-10-22 |
| 1740777234 | Susan Ko-velez | Physician Assistant | 941 Rte 35, Middletown, NJ 07748-2601 | 2018-04-19 |
| 1265880918 | Jared Marshall | Physician Assistant | 222 Carriage Crossing Ln, Middletown, CT 06457-5862 | 2016-06-02 |
| 1184921322 | Juliane Natasha Everest | Physician Assistant | 1680 Route 35, Family Wellness Center, Middletown, NJ 07748 | 2011-02-24 |
| 1326271412 | Kristin Myers | Physician Assistant | 896 Washington St, Middletown, CT 06457-2912 | 2009-08-24 |
| 1245410422 | Kristine Carta Lane | Physician Assistant | 540 Saybrook Rd Ste 110, Middletown, CT 06457-4711 | 2007-11-06 |
| 1003001587 | Mary Chau Tran | Physician Assistant | 400 Saybrook Rd Ste 205, Middletown, CT 06457-4775 | 2007-09-07 |
| 1417153131 | Kimberly Marie Dembeck | Physician Assistant | 75 Crystal Run Rd Ste G40, Middletown, NY 10941-7000 | 2007-06-21 |
| 1659460236 | Irene Eng | Physician Assistant | 25 Myrtle Ave, Middletown, NY 10940-4122 | 2006-10-12 |
| 1821001298 | Byron Edward Schieber | Physician Assistant | 81 Constellation Ct, Middletown, PA 17057-5086 | 2006-08-15 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 06457 |
Please comment or provide details below to improve the information on MS. SHANNON PACKER.
| 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.