Shannon Elizabeth Klvana

Primary specialty

SpecialistTaxonomy code 174400000X

License

435686101 Issued in NY

Practice address

30 Lakewood Ave
Ronkonkoma, NY 11779-5620

Phone

(631) 379-4200

NPI assigned

Dec 11, 2012

Last updated

Dec 11, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1144565516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 LAKEWOOD AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117795620",
            "telephone_number": "631-379-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 LAKEWOOD AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117795620",
            "telephone_number": "631-379-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLVANA",
        "first_name": "SHANNON",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-11",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "435686101",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "435688101",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "435687101",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "435685101",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayesha Khatri
• June Kiefer, MSN CS NPP
• Sophia P Kim
• Lauren Rose Kinkaid
• Lynn Marie Klingenberger, RN
• Stephanie Marie Knauf
• Kristen Knipfing, MA
• Carey Knoell
• David Kochnower, PA
• Lori Beth Koerner

• Specialist in Ronkonkoma, NY
• Providers in Ronkonkoma, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.