Shannon Marie Sullivan (NPI# 1972998680, PAC ID# 8820365976) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1972998680 |
| PAC ID by PECOS | 8820365976 |
| Professional Enrollment ID | I20181002000755 |
| Full Name | Shannon Marie Sullivan |
| Organization Legal Name | THEDACARE INCORPORATED |
| Address |
2005 Midway Rd Menasha WI 54952-7002 |
| Phone Number | 9208328500 |
| Gender | F |
| Medical School | LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE |
| Graduation Year | 2015 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 1759294887 |
| Number of Group Practice Members | 478 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520045 | THEDA CLARK MEDICAL CENTER |
| 520160 | THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC |
| Address | Phone | Organization |
|---|---|---|
| 2005 Midway Rd, Menasha, WI 54952-7002 | 9208328500 | THEDACARE INCORPORATED |
| Organization Legal Name | THEDACARE INCORPORATED |
| Physicians | 485 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrew J Kubisch | Physician Assistant | Thedacare Incorporated | 1405 Mill St, New London, WI 54961-2155 |
| Anna L King | Physician Assistant | Thedacare Incorporated | 1818 N Meade St Room, N255, Appleton, WI 54911-3454 |
| Roger B Collins | Orthopedic Surgery | Thedacare Incorporated | 130 2nd St, Neenah, WI 54956-2883 |
| Jennifer E Szmanda | Pediatric Medicine | Thedacare Incorporated | 640 Deerwood Ave, Neenah, WI 54956-7110 |
| Elizabeth A Barthel | Nurse Practitioner | Thedacare Incorporated | 2500 E Capitol Dr, Fl 2, Appleton, WI 54911-8735 |
| Carmen L Miller | Nurse Practitioner | Thedacare Incorporated | 710 Riverside Dr, Waupaca, WI 54981-1941 |
| Kathleen M Erdahl | Nurse Practitioner | Thedacare Incorporated | 1000 W Northland Ave, Appleton, WI 54914-1419 |
| Jennifer L Kohnke | Nurse Practitioner | Thedacare Incorporated | 670 Country Rd A, Green Lake, WI 54941-8608 |
| Taylor B Doberstein | Rheumatology | Thedacare Incorporated | 200 Theda Clark Medical Plaza, Suite 350, Neenah, WI 54956-2790 |
| Rachel A Savage | Nurse Practitioner | Thedacare Incorporated | 400 S Maple St, Black Creek, WI 54106-9787 |
| Street Address |
2005 MIDWAY RD |
| City | MENASHA |
| State | WI |
| Zip | 54952-7002 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Katie M Armatoski | Qualified Audiologist | Ear Nose and Throat Specialists of Wisconsin Sc | 2005 Midway Rd, Menasha, WI 54952-7002 |
| Caroline A Abel | Nurse Practitioner | Thedacare Incorporated | 2005 Midway Rd, Menasha, WI 54952-7002 |
| Holly A Rusch | Qualified Audiologist | Ear Nose and Throat Specialists of Wisconsin Sc | 2005 Midway Rd, Menasha, WI 54952-7002 |
| Robert B Prehn | Otolaryngology | Ear Nose and Throat Specialists of Wisconsin Sc | 2005 Midway Rd, Menasha, WI 54952-7002 |
| Erin L Krueger | Qualified Audiologist | Ear Nose and Throat Specialists of Wisconsin Sc | 2005 Midway Rd, Menasha, WI 54952-7002 |
| Cheryl A Pucci | Nurse Practitioner | Ear Nose and Throat Specialists of Wisconsin Sc | 2005 Midway Rd, Menasha, WI 54952-7002 |
| Rebecca J Philpot | Nurse Practitioner | Thedacare Incorporated | 2005 Midway Rd, Menasha, WI 54952-7002 |
| Janine M Buffo | Family Medicine | Thedacare Incorporated | 2005 Midway Rd, Menasha, WI 54952-7002 |
| Tamara S Mischka | Qualified Audiologist | Ear Nose and Throat Specialists of Wisconsin Sc | 2005 Midway Rd, Menasha, WI 54952-7002 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Felicia Houk | Chiropractic | 1403 Appleton Rd, Menasha, WI 54952-1101 | |
| Ann E Kirchner | Clinical Social Worker | Family Services of Northeast Wisconsin Inc | 1810 Appleton Rd, Menasha, WI 54952-1110 |
| Yong Li | Psychiatry | Thedacare Incorporated | 1095 Midway Rd, Menasha, WI 54952-1115 |
| John Thomas Beld | Psychiatry | Thedacare Incorporated | 1095 Midway Rd, Menasha, WI 54952-1115 |
| Sherrill D Downey | Clinical Social Worker | Thedacare Incorporated | 1095 Midway Rd, Menasha, WI 54952-1115 |
| Michael J Panzer | Psychiatry | Thedacare Incorporated | 1095 Midway Rd, Menasha, WI 54952-1115 |
| Jodi R Owen | Psychologist, Clinical | Thedacare Incorporated | 1095 Midway Rd, Menasha, WI 54952-1115 |
| Thomas R Groh | Psychologist, Clinical | Thedacare Incorporated | 1095 Midway Rd, Menasha, WI 54952-1115 |
| Christopher J Kuhn | Clinical Social Worker | Thedacare Incorporated | 1095 Midway Rd, Menasha, WI 54952-1115 |
| Tammy L Hietpas | Psychologist, Clinical | Thedacare Incorporated | 1095 Midway Rd, Menasha, WI 54952-1115 |
| Find all physicians in zip 54952 | |||
| City | MENASHA |
| Zip Code | 54952 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | MENASHA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Shannon Marie Sullivan.
| 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.