| Heather Marian Shannon, NP | |
|
522 S 4th St Ste 500, Fulton, NY 13069 | |
| (315) 598-4740 | |
| (315) 598-4728 |
| Full Name | Heather Marian Shannon |
|---|---|
| Gender | Female |
| Speciality | Certified Nurse Midwife (cnm) |
| Experience | 28 Years |
| Location | 522 S 4th St Ste 500, Fulton, New York |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790775005 | NPI | - | NPPES |
| 02381762 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367A00000X | Advanced Practice Midwife | F000678-1 (New York) | Secondary |
| 363LW0102X | Nurse Practitioner - Women's Health | 00420826 (New York) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Oswego Hospital | Oswego, NY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Oswego County Opportunities, Inc. | 0749176436 | 3 |
| Entity Name | Oswego County Opportunities, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740396324 PECOS PAC ID: 0749176436 Enrollment ID: O20040227000780 |
| Entity Name | University Ob/gyn Associates, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235170150 PECOS PAC ID: 9133117740 Enrollment ID: O20040503001562 |
| Mailing Address | Practice Location Address |
|---|---|
| Heather Marian Shannon, NP 239 Oneida Street, Attn: Paula Baker, Fulton, NY 13069 Ph: (315) 598-4715 | Heather Marian Shannon, NP 522 S 4th St Ste 500, Fulton, NY 13069 Ph: (315) 598-4740 |
Mrs. Rebecca Dottolo, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 510 S 4th St, Fulton, NY 13069 Phone: 315-592-3500 | |
Samantha Goutermout, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 522 S 4th St, Fulton, NY 13069 Phone: 315-592-3930 Fax: 315-592-3932 | |
Mrs. Cheryl Susan Martin-schroeder, M.S.N.,P.N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 63 S 1st St, Fulton, NY 13069 Phone: 315-598-6785 Fax: 315-592-3571 | |
Shannon M Woods, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 98 N 2nd St, Fulton, NY 13069 Phone: 315-326-3555 | |
Anthony Bryant, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 510 S 4th St Ste 600, Fulton, NY 13069 Phone: 315-598-4790 Fax: 315-593-6195 | |
Mrs. Joanne Lomber, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 941 S 1st St, Fulton, NY 13069 Phone: 315-593-1729 | |
Ms. Claire Ann Vacca, N,P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 21 N 2nd St, Fulton, NY 13069 Phone: 315-598-7105 Fax: 315-598-4857 |