Shannon Boney Mathis (NPI# 1013472232, PAC ID# 2264773894) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1013472232 |
| PAC ID by PECOS | 2264773894 |
| Professional Enrollment ID | I20190409002353 |
| Full Name | Shannon Boney Mathis |
| Organization Legal Name | NOVANT MEDICAL GROUP INC |
| Address |
13 Medical Campus Dr Nw Suite 102 Supply NC 28462-4093 |
| Phone Number | 9107545988 |
| Gender | F |
| Medical School | UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE |
| Graduation Year | 2018 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 1153234893 |
| Number of Group Practice Members | 1778 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 340158 | NOVANT HEALTH BRUNSWICK MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 13 Medical Campus Dr Nw, Suite 102, Supply, NC 28462-4093 | 9107545988 | NOVANT MEDICAL GROUP INC |
| Organization Legal Name | NOVANT MEDICAL GROUP INC |
| Physicians | 1795 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eugene Y Wang | Family Medicine | Novant Medical Group Inc | 2225 Freedom Dr, Charlotte, NC 28208-1000 |
| Cristina Saxon Hreso | Registered Dietitian Or Nutrition Professional | Novant Medical Group Inc | 14215 Ballantyne Corporate Pl, Suite 240, Charlotte, NC 28277-3875 |
| Jeffrey L Williams | Obstetrics/gynecology | Novant Medical Group Inc | 2909 Maplewood Ave, Winston Salem, NC 27103-4009 |
| Shannon M. Roche | Family Medicine | Novant Medical Group Inc | 8420 University Exec Park Dr, Suite 850, Charlotte, NC 28262-1308 |
| Laura Walker Justice | Registered Dietitian Or Nutrition Professional | Novant Medical Group Inc | 125 Baldwin Ave, Suite 200, Charlotte, NC 28204-3370 |
| Jennifer Susanne Harvey | Family Medicine | Novant Medical Group Inc | 1730 Kernersville Medical Pkwy, Suite 204, Kernersville, NC 27284-7198 |
| Zion Ko Lamm | Internal Medicine | Novant Medical Group Inc | 301 S College St, Suite 250, Charlotte, NC 28202-6035 |
| Ellen Greear | Nurse Practitioner | Novant Medical Group Inc | 200 Greenwich Rd, Charlotte, NC 28211-2316 |
| Allen J Shepard | Family Medicine | Novant Medical Group Inc | 14230 Hunters Rd, Huntersville, NC 28078-7335 |
| Charis Craig Bostian | Nurse Practitioner | Novant Medical Group Inc | 1965s Us 29 Hwy, China Grove, NC 28023-5684 |
| Street Address |
13 MEDICAL CAMPUS DR NW SUITE 102 |
| City | SUPPLY |
| State | NC |
| Zip | 28462-4093 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michelle L Shepherd | Certified Registered Nurse Anesthetist (crna) | Nmg Southpark Services, LLC | 13 Medical Campus Dr Nw, Suite 101, Supply, NC 28462-4093 |
| Frank L Holt | Internal Medicine | Novant Medical Group Inc | 13 Medical Campus Dr Nw, Suite 102, Supply, NC 28462-4093 |
| Amy Y Gorman | Certified Registered Nurse Anesthetist (crna) | Nmg Southpark Services, LLC | 13 Medical Campus Dr Nw, Suite 101, Supply, NC 28462-4093 |
| Pamela A Betz | Certified Registered Nurse Anesthetist (crna) | Nmg Southpark Services, LLC | 13 Medical Campus Dr Nw, Suite 101, Supply, NC 28462-4093 |
| Lisa Ann Rodovich | Certified Registered Nurse Anesthetist (crna) | Nmg Southpark Services, LLC | 13 Medical Campus Dr Nw, Suite 101, Supply, NC 28462-4093 |
| Barbara Joan Paolucci | Nurse Practitioner | Novant Medical Group Inc | 13 Medical Campus Dr Nw, Suite 102, Supply, NC 28462-4093 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rita M Desimone | Occupational Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Benjamin Clark | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Mary F Stoker | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Thomas Lair | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Kurt Kildow | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Scott Thomas | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Brittainy R Edwards Kidlow | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Kathleen May Franzen | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Vaughn Leigh Moore | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Suite 204, Supply, NC 28462-0001 |
| Erin Brooke Bostic | Physical Therapy | Carolina Rehabilitation Inc | 20 Medical Campus Dr, Supply, NC 28462-0001 |
| Find all physicians in zip 28462 | |||
| City | SUPPLY |
| Zip Code | 28462 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | SUPPLY + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Shannon Boney Mathis.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.