Grant Shannon (NPI# 1881139863, PAC ID# 4486930641) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1881139863 |
| PAC ID by PECOS | 4486930641 |
| Professional Enrollment ID | I20170425000045 |
| Full Name | Grant Shannon |
| Organization Legal Name | ALICE HYDE MEDICAL CENTER |
| Address |
133 Park St Malone NY 12953-1243 |
| Phone Number | 5184812545 |
| Gender | M |
| Graduation Year | 2016 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4082525837 |
| Number of Group Practice Members | 65 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330084 | ALICE HYDE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 133 Park St, Malone, NY 12953-1243 | 5184812545 | ALICE HYDE MEDICAL CENTER |
| Organization Legal Name | ALICE HYDE MEDICAL CENTER |
| Physicians | 50 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Megan E Gagner | Certified Nurse Midwife (cnm) | Alice Hyde Medical Center | 16 3rd St A, Malone, NY 12953-1305 |
| Rodolfo L Dy | General Surgery | Alice Hyde Medical Center | 16 3rd St B, Malone, NY 12953-1305 |
| Steven Shamosh | Internal Medicine | Alice Hyde Medical Center | 183 Park St, Malone, NY 12953-1238 |
| Sarah A Moore | Physician Assistant | Alice Hyde Medical Center | 24 4th St, Suite 4, Malone, NY 12953-1350 |
| Joseph E Robinson | Family Medicine | Alice Hyde Medical Center | 45 6th St, Malone, NY 12953-1246 |
| Kathleen Lauzon | Nurse Practitioner | Alice Hyde Medical Center | 577 County Route 1, Fort Covington, NY 12937-2805 |
| Anne E Mcilhenny | Registered Dietitian Or Nutrition Professional | Alice Hyde Medical Center | 20 4th St, Malone, NY 12953-1339 |
| Rowan Fish | Dermatology | Alice Hyde Medical Center | 969 State Rt, Moira, NY 12957 |
| Mia Ross | Nurse Practitioner | Alice Hyde Medical Center | 23 4th St, Suite 1, Malone, NY 12953-1331 |
| Myrna A Sanchez | Internal Medicine | Alice Hyde Medical Center | 187 Park St, Suite 2, Malone, NY 12953-1233 |
| Street Address |
133 PARK ST |
| City | MALONE |
| State | NY |
| Zip | 12953-1243 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shafiu O Ololade | Hospitalist | Apogee Medical Group, New York, PC | 133 Park St, Malone, NY 12953-1244 |
| Gaboy Jupiter | Nurse Practitioner | Apogee Medical Group, New York, PC | 133 Park St, Malone, NY 12953-1244 |
| Nidal Makhoul | Cardiovascular Disease (cardiology) | Lake Champlain Physician Services | 133 Park St, Malone, NY 12953-1243 |
| James E Tkacik | Physician Assistant | Apogee Medical Group, New York, PC | 133 Park St, Malone, NY 12953-1244 |
| Rajiv Pant | Internal Medicine | Apogee Medical Group, New York, PC | 133 Park St, Malone, NY 12953-1244 |
| Brinda Muthuswamy | Hospitalist | Apogee Medical Group, New York, PC | 133 Park St, Malone, NY 12953-1244 |
| Aiesha Clayton | Physician Assistant | Apogee Medical Group, New York, PC | 133 Park St, Malone, NY 12953-1244 |
| Christopher S Palma | Cardiovascular Disease (cardiology) | Lake Champlain Physician Services | 133 Park St, Malone, NY 12953-1243 |
| Anita N Lwanga | Hospitalist | Apogee Medical Group, New York, PC | 133 Park St, Malone, NY 12953-1244 |
| Rebecca R Snickles | Nurse Practitioner | Alice Hyde Medical Center | 133 Park St, Malone, NY 12953-1243 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joel T Santy | Chiropractic | Adirondack Region Chiropractic PC | 9 Finney Blvd, Malone, NY 12953-1038 |
| Tracy A Trudel | Chiropractic | Adirondack Region Chiropractic PC | 9 Finney Blvd, Malone, NY 12953-1038 |
| Gary L Hanley | Optometry | 22 Finney Blvd, Malone, NY 12953-1039 | |
| Noni H Irish | Clinical Social Worker | Citizen Advocates, Inc | 209 Park St, Malone, NY 12953-1228 |
| Myrna A Sanchez | Internal Medicine | Alice Hyde Medical Center | 187 Park St, Suite 2, Malone, NY 12953-1233 |
| Marie W Haggarty | Physician Assistant | Alice Hyde Medical Center | 187 Park St, Suite 2, Malone, NY 12953-1233 |
| Vladimir Medved | Pain Management | Alice Hyde Medical Center | 187 Park St, Suite 2, Malone, NY 12953-1233 |
| David J Griffin | Physician Assistant | Alice Hyde Medical Center | 187 Park St, Suite 2, Malone, NY 12953-1233 |
| Steven Shamosh | Internal Medicine | Alice Hyde Medical Center | 183 Park St, Malone, NY 12953-1238 |
| Derek J Reynolds | Nurse Practitioner | Alice Hyde Medical Center | 183 Park St, Malone, NY 12953-1238 |
| Find all physicians in zip 12953 | |||
| City | MALONE |
| Zip Code | 12953 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | MALONE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Grant Shannon.
| 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.