| NPI | 1003073396 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2008-05-22 |
| Last Updated | 2020-10-25 |
| Mailing Address | Po Box 751803 Charlotte, NC 28275-1803 United States Phone: (336) 277-2000 | Fax: (336) 277-2050 📍 View Map |
| Primary Practice Address | 186 Kimel Park Dr Winston Salem, NC 27103-6946 United States Phone: (336) 277-2000 | Fax: (336) 277-2050 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | NC | 5921382 | — |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 207RC0000X – Internal Medicine, Cardiovascular Disease | NC | 2009-00666 |
| Yes | 207UN0901X – Nuclear Medicine, Nuclear Cardiology | NC | 2009-00666 |
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About NPI 1003073396
Shannon Mitchell St Clair MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1003073396. The primary specialty listed is Nuclear Medicine, Nuclear Cardiology. The provider is located in Winston Salem, NC. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2008-05-22. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1003073396?
NPI 1003073396 belongs to Shannon Mitchell St Clair MD, a Nuclear Medicine, Nuclear Cardiology in Winston Salem, NC. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1003073396 active?
The current status of NPI 1003073396 in the NPPES registry is Active. The record was last updated on 2020-10-25.
What specialty is NPI 1003073396?
NPI 1003073396 is classified under the taxonomy Nuclear Medicine, Nuclear Cardiology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1003073396?
You can verify NPI 1003073396 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1003073396?
The primary practice address on file for NPI 1003073396 is 186 Kimel Park Dr, Winston Salem, NC 27103-6946. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1003073396 issued?
NPI 1003073396 was first issued (enumerated) on 2008-05-22. The NPPES record was last updated on 2020-10-25.
Practice Location Map
Shannon Mitchell St Clair is located at 186 Kimel Park Dr, Winston Salem, NC. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Shannon Mitchell St Clair. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1003073396. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Internal Medicine, Cardiovascular Disease | 2009-00666 | NC |
| Nuclear Medicine, Nuclear Cardiology | 2009-00666 | NC |