Shannon K Black (NPI# 1629184213, PAC ID# 4688566052) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1629184213 |
| PAC ID by PECOS | 4688566052 |
| Professional Enrollment ID | I20040329001325 |
| Full Name | Shannon K Black |
| Organization Legal Name | ASCENSION PHYSICAL THERAPY LLC |
| Address |
6200 Lake Otis Pkwy Suite 104 Anchorage AK 99507-2098 |
| Phone Number | 9077706693 |
| Gender | F |
| Credential | PT |
| Medical School | UNIVERSITY OF WISCONSIN MEDICAL SCHOOL |
| Graduation Year | 1993 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 6406758085 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 6200 Lake Otis Pkwy, Suite 104, Anchorage, AK 99507-2098 | 9077706693 | ASCENSION PHYSICAL THERAPY LLC |
| Organization Legal Name | ASCENSION PHYSICAL THERAPY LLC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennah L Jones | Physical Therapy | Ascension Physical Therapy LLC | 6200 Lake Otis Pkwy, Suite 104, Anchorage, AK 99507-2098 |
| Meredith R Autrey | Physical Therapy | Ascension Physical Therapy LLC | 6200 Lake Otis Pkwy, Suite 104, Anchorage, AK 99507-2098 |
| David Disselbrett | Physical Therapy | Ascension Physical Therapy LLC | 6200 Lake Otis Pkwy, Suite 104, Anchorage, AK 99507-2098 |
| Street Address |
6200 LAKE OTIS PKWY SUITE 104 |
| City | ANCHORAGE |
| State | AK |
| Zip | 99507-2098 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennah L Jones | Physical Therapy | Ascension Physical Therapy LLC | 6200 Lake Otis Pkwy, Suite 104, Anchorage, AK 99507-2098 |
| Meredith R Autrey | Physical Therapy | Ascension Physical Therapy LLC | 6200 Lake Otis Pkwy, Suite 104, Anchorage, AK 99507-2098 |
| David Disselbrett | Physical Therapy | Ascension Physical Therapy LLC | 6200 Lake Otis Pkwy, Suite 104, Anchorage, AK 99507-2098 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Garrett P Haponski | Chiropractic | 2217 E Tudor Rd, Suite 16, Anchorage, AK 99507-1068 | |
| Joel M Everard | Physical Therapy | 2704 E Tudor Rd, Anchorage, AK 99507-1136 | |
| Robert Hilleman | Physician Assistant | Ideal Telemedicine Services LLC | 2421 E Tudor Rd, Suite 108, Anchorage, AK 99507-1166 |
| Michael E Merrick | Family Medicine | Ideal Telemedicine Services LLC | 2421 E Tudor Rd, Suite 108, Anchorage, AK 99507-1166 |
| Dolores I Van Bourgondien | Nurse Practitioner | Ideal Option, Pllc | 2421 E Tudor Rd, Suite 108, Anchorage, AK 99507-1166 |
| Jeffrey C Trotter | Physical Therapy | 2421 E Tudor Rd, 103 Frontier Therapy, Anchorage, AK 99507-1166 | |
| Tina Marie Demure | Nurse Practitioner | Ideal Option, Pllc | 2421 E Tudor Rd, Suite 108, Anchorage, AK 99507-1166 |
| Malissa Corbett | Physical Therapy | Jeffrey C Trotter | 2421 E Tudor Rd, Anchorage, AK 99507-1166 |
| Kelly L Ketz | Chiropractic | 5905 Lake Otis Pkwy, Suite B, Anchorage, AK 99507-1700 | |
| Lisa M Radley | Physical Therapy | Arctic Rehabilitation and Physical Therapy Anchorage LLC | 5701 Lake Otis Pkwy, Suite 100, Anchorage, AK 99507-1778 |
| Find all physicians in zip 99507 | |||
| City | ANCHORAGE |
| Zip Code | 99507 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | ANCHORAGE + PHYSICAL THERAPY |
Please comment or provide details below to improve the information on Shannon K Black.
| 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.