SHANNON HUNTSMAN (NPI# 1902351802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902351802 |
| Entity Type | Individual |
| Full Name | SHANNON HUNTSMAN |
| Other Name | SHANNON NECHOLE CORNELIUS |
| Practice Address |
167 Polk St Suite 300 Watertown NY 13601-2097 |
| Mailing Address |
Po Box 6550 Watertown NY 13601-6550 |
| Practice Telephone | 3157827445 |
| Practice Fax Number | 3157791184 |
| Mailing Telephone | 3157827445 |
| Mailing Fax Number | 3157791184 |
| Enumeration Date | 2016-08-20 |
| Last Update Date | 2016-08-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
167 POLK ST SUITE 300 |
| City | WATERTOWN |
| State | NY |
| Zip Code | 13601-2097 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770625527 | The Childrens Hm Jefferson Mh | Case Management | 167 Polk St, Suite 300, Watertown, NY 13601-2763 | 2007-02-12 |
| 1346771110 | Livia Margaret Kubica | Social Worker | 167 Polk St, Suite 300, Watertown, NY 13601-2097 | 2017-03-23 |
| 1043754864 | Shay Eileen Park Richards | Social Worker | 167 Polk St, Suite 300, Watertown, NY 13601-2097 | 2016-12-13 |
| 1184176273 | David Hall | Social Worker | 167 Polk St, Suite 300, Watertown, NY 13601-2097 | 2016-10-25 |
| 1144770637 | Angela Matthews | Student in an Organized Health Care Education/Training Program | 167 Polk St, Suite 300, Watertown, NY 13601-2097 | 2016-10-07 |
| 1528517174 | Brenda Bonnie Messer | Social Worker | 167 Polk St, Suite 300, Watertown, NY 13601-2097 | 2016-09-23 |
| 1154877546 | Kristen M Martin | Counselor | 167 Polk St, Suite 300, Watertown, NY 13601-2097 | 2016-08-26 |
| 1891249066 | Angela Steffan Nasworthy | Student in an Organized Health Care Education/Training Program | 167 Polk St, Suite 300, Watertown, NY 13601-2097 | 2016-08-05 |
| 1518411784 | Olga Harbuz | Student in an Organized Health Care Education/Training Program | 167 Polk St, Suite 300, Watertown, NY 13601-2097 | 2016-08-05 |
| 1609320993 | Cassondra Davis | Student in an Organized Health Care Education/Training Program | 167 Polk St, Suite 300, Watertown, NY 13601-2097 | 2016-08-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801414156 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 122 Court Street, Empsall Bldg, Room 212, Watertown, NY 13601 | 2020-07-13 |
| 1083231377 | Katherine Anne Cahill | Counselor | 22679 Duffy Road, Watertown, NY 13601 | 2020-07-02 |
| 1851855431 | Hanna Kearney | Physical Therapist | 20053 Summit View Blvd Ste 2, Watertown, NY 13601 | 2019-01-28 |
| 1578039905 | North Country Counseling Services LLC | Counselor | 210 Court St. Suite 4, Watertown, NY 13601 | 2018-10-24 |
| 1073004388 | Megan Anna O'brien | Counselor | 221 S Rutland Street, Watertown, NY 13601 | 2018-05-22 |
| 1558860536 | Kimberly Lynne Amelio | Specialist | 24850 Hinds Rd, Watertown, NY 13601 | 2018-02-06 |
| 1952840050 | Alberto Gonzalez | Social Worker | 211 Jb Wise Plaza, Watertown, NY 13601 | 2017-02-22 |
| 1073967386 | Amanda Pisarski | Licensed Practical Nurse | 26713 Nys Rte 12, Watertown, NY 13601 | 2016-04-22 |
| 1396137709 | Daniel Ernest Morgan | Neuromusculoskeletal Medicine & OMM | 21101 Ny-12f, Building 2, Suite 7, Watertown, NY 13601 | 2015-02-21 |
| 1568868131 | Megan E. Zamora | Dental Hygienist | 14652-b Cedar Way, Watertown, NY 13601 | 2014-11-10 |
| Find all providers in zip 13601 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730795147 | Suong Bui | Student in an Organized Health Care Education/Training Program | 141 Breen Ave, Watertown, NY 13601-7394 | 2020-09-21 |
| 1871113605 | Jairo Matthew Amarillo | Student in an Organized Health Care Education/Training Program | 203 Sycamore St Unit 2, Watertown, MA 02472-1058 | 2020-04-22 |
| 1649899592 | Tara Toloui Rahimabadi | Student in an Organized Health Care Education/Training Program | 275 Main St Apt 704, Watertown, MA 02472-4309 | 2020-04-10 |
| 1710516117 | Karla Bakke | Student in an Organized Health Care Education/Training Program | 117 Riverlawn Ave, Watertown, WI 53094-4013 | 2020-04-07 |
| 1790327963 | Michelle Blitzman | Student in an Organized Health Care Education/Training Program | 2c Locust Ln, Watertown, MA 02472-1733 | 2019-10-09 |
| 1639664634 | Angela Tutein | Student in an Organized Health Care Education/Training Program | 11a Cuba St, Watertown, MA 02472-2342 | 2018-06-22 |
| 1811310428 | Ryan Renzella | Student in an Organized Health Care Education/Training Program | 48 Prospect St, Watertown, MA 02472-3113 | 2014-02-03 |
| 1073891222 | Alexander Pantelis Tinios | Student in an Organized Health Care Education/Training Program | 163 Townline Hwy, Watertown, CT 06795 | 2011-07-21 |
| 1992316657 | Michele Kolb | Student in an Organized Health Care Education/Training Program | 211 J.b. Wise Plaza, Watertown, NY 13601 | 2020-08-14 |
| 1518578368 | Brieanna Lewis | Student in an Organized Health Care Education/Training Program | 211 J.b. Wise Plaza, Watertown, NY 13601-1360 | 2020-08-14 |
| Find all providers in WATERTOWN | ||||
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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.