MR. WILLIAM SHANE MCCLANAHAN (NPI# 1962493932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962493932 |
| Entity Type | Individual |
| Full Name | MR. WILLIAM SHANE MCCLANAHAN |
| Credential | PA-C |
| Practice Address |
1409 Kingsley Ave Ste 14a Orange Park FL 32073-4541 |
| Practice Telephone | 9042133555 |
| Practice Fax Number | 9042721222 |
| Mailing Telephone | 9042133555 |
| Mailing Fax Number | 9042721222 |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2008-10-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA2114 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 291267800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477583219 | William A Mcclanahan | Dentist | 2461 Helton Dr, Florence, AL 35630-1067 | 2006-07-04 |
| 1770661472 | William Clinton Mcclanahan | Ophthalmology | 2025 Morse Ave, Sacramento, CA 95825-2115 | 2006-11-01 |
| 1518944669 | William Harvey Mcclanahan Jr. | Internal Medicine | 70 Plaza Dr, Northside Medical, Pell City, AL 35125-9314 | 2005-12-29 |
| Street Address |
1409 KINGSLEY AVE STE 14A |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073-4541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821092503 | Paul Christopher Duff | Physician Assistant | 1564 Kingsley Ave Ste 300, Orange Park, FL 32073-4521 | 2005-06-09 |
| 1588093611 | James Tyler Hawkins | Physician Assistant | 108 Kingsley Ave, Orange Park, FL 32073-5685 | 2013-11-08 |
| 1588909659 | Amanda Jeanette Shinko | Physician Assistant | 2140 Kingsley Ave, Suite 1, Orange Park, FL 32073-5180 | 2012-11-30 |
| 1235489287 | Mark A Arrigenna | Physician Assistant | 2300 Park Ave, Suite 203, Orange Park, FL 32073-5571 | 2012-09-18 |
| 1326260423 | Dennis Kevin Obrien | Physician Assistant | 1689 Eagle Harbor Pkwy, Orange Park, FL 32003-4802 | 2007-05-02 |
| 1154482032 | Jerry Dennis Erkert | Physician Assistant | 1895 Kingsley Ave, Suite 803, Orange Park, FL 32073-4466 | 2006-12-13 |
| 1649354242 | Sarah Wetzlar Perkins | Physician Assistant | 1680 Eagle Harbor Pkwy, Suite A, Orange Park, FL 32003-4821 | 2006-10-24 |
| 1215023775 | Tracey Amanda Bleau | Physician Assistant | 2021 Kingsley Ave, Suite 101, Orange Park, FL 32073-5174 | 2006-10-04 |
| 1760496269 | Pinki Patel | Physician Assistant | 2100 Kingsley Ave, Orange Park, FL 32073 | 2006-07-28 |
| 1992740831 | Barbara A Kopit | Physician Assistant | 1564 Kingsley Ave, Orange Park, FL 32073-4511 | 2006-06-17 |
| Find all providers in ORANGE PARK | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
Please comment or provide details below to improve the information on MR. WILLIAM SHANE MCCLANAHAN.
| 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.