Active NPI
Shannon North, PA-C
- Medical Physician Assistant
- Bronx, NY
National Provider Identifier
1083965768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 016104-1
- Practice address
- 3424 Kossuth Ave
North Central Bronx Hospital Emergency Dept 1a-10
Bronx, NY 10467-2410 - Phone
- (718) 519-3021
- NPI assigned
- Sep 21, 2012
- Last updated
- Nov 15, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 016104-1 | NY | Primary |
Addresses
Primary practice location
3424 Kossuth Ave
North Central Bronx Hospital Emergency Dept 1a-10
Bronx, NY 10467-2410
Mailing address
395 S End Ave Apt 34K
New York, NY 10280-1053
Phone (352) 514-0993
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016104-1 | NY | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510704000000",
"number": "1083965768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "395 S END AVE APT 34K",
"city": "NEW YORK",
"state": "NY",
"postal_code": "102801053",
"telephone_number": "352-514-0993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3424 KOSSUTH AVE",
"address_2": "NORTH CENTRAL BRONX HOSPITAL EMERGENCY DEPT 1A-10",
"city": "BRONX",
"state": "NY",
"postal_code": "104672410",
"telephone_number": "718-519-3021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORTH",
"first_name": "SHANNON",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-21",
"last_updated": "2017-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "016104-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
- North Central Hospital
- North Coast Physical Therapy & Rehab, P.C.
- North Point Medical Associates PC
- North Shore Hematology Oncology Associates PC (Ny Cancer & Blood Specialists)
- North State Healthy Solutions LLC (HALDEY Pharmaceutical Compounding)
- Northeast Bronx Day Care Center, Inc.
- Northeast Bronx OB/GYN Associates, P.C.
- Northern Bronx Physical Therapy PC
- Northland Hearing Centers, Inc. (Audibel Hearing Center)
- Northland Hearing Centers, Inc. (Audibel Hearing Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.