Shannon Clarke Campbell Nedelka, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

12807 Issued in NH

Practice address

7 Dreyer Way
Rochester, NH 03867-2775

Phone

(603) 332-6413

Fax

(603) 335-1076

NPI assigned

Nov 3, 2005

Last updated

Dec 20, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NH, MO, IL, TX4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Diagnostic Radiology

Education

University of Texas Medical Branch at Galveston, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinical Radiologists SCGroup PAC ID 3476540873, 32 clinicians

Mands Radiology Associates PAGroup PAC ID 3173505088, 54 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Medical Center Hospital, San Antonio, TX, CCN 450058
• Memorial Hospital Hospital, Belleville, IL, CCN 140185
• Resolute Health Hospital Hospital, New Braunfels, TX, CCN 670098
• Westover Hills Baptist Hospital Hospital, San Antonio, TX, CCN 670333
• Alton Memorial Hospital Hospital, Alton, IL, CCN 140002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clinical Radiologists, S.C.

  • Diagnostic Radiology Physician
  • Springfield, IL
  • NPI 1063469252

  MO, NH

  Medicare reassignment Care Compare group NPD
• M&S Radiology Associates, PA

  • Specialist
  • San Antonio, TX
  • NPI 1265423693

  NH

  Medicare reassignment Care Compare group NPD
• Seacoast Radiology, PA

  • Diagnostic Radiology Physician
  • Dover, NH
  • NPI 1427020395
  Medicare reassignment NPD
• VHS San Antonio Imaging Partners, LP

  • Diagnostic Radiology Physician
  • San Antonio, TX
  • NPI 1457350993
  Medicare reassignment NPD
• Schuyler County Hospital District

  • Critical Access Hospital
  • Rushville, IL
  • NPI 1013969112
  NPD (past)
• VHS San Antonio Partners, LLC

  dba Westover Hills Baptist Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1831970532
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alton Memorial Hospital

  • Ambulance
  • Alton, IL
  • NPI 1063669117

  Hospital

  Care Compare affiliation
• Alton Memorial Hospital

  • General Acute Care Hospital
  • Alton, IL
  • NPI 1548278476
  Care Compare affiliation
• Protestant Memorial Medical Center, Inc.

  dba Memorial Hospital

  • General Acute Care Hospital
  • Belleville, IL
  • NPI 1982796181
  Care Compare affiliation
• Resolute Hospital Company, LLC

  dba Resolute Health Hospital

  • General Acute Care Hospital
  • New Braunfels, TX
  • NPI 1427472463
  Care Compare affiliation
• VHS San Antonio Partners LLC

  dba Baptist Medical Center

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1598744856
  Care Compare affiliation
• VHS San Antonio Partners, LLC

  dba Westover Hills Baptist Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1831970532
  Care Compare affiliation

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198108800000",
    "number": "1174514509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DREYER WAY",
            "city": "ROCHESTER",
            "state": "NH",
            "postal_code": "038672775",
            "telephone_number": "603-332-6413",
            "fax_number": "603-335-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 DREYER WAY",
            "city": "ROCHESTER",
            "state": "NH",
            "postal_code": "038672775",
            "telephone_number": "603-332-6413",
            "fax_number": "603-335-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL NEDELKA",
        "first_name": "SHANNON",
        "middle_name": "CLARKE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2007-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NH",
            "license": "12807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30205273",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "01Y008533NH01",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annette Busick
• Alexis M Byrd, MS, CCC-SLP
• Julia Caddell, BSW
• Elizabeth Ann Callahan, OTR/L
• Jennifer Camp
• Shawn Campbell, MD
• Philip Lee Canter, RPH
• Jocelyn F Caple, MD
• Richard Cappello, DO
• Amanda Christine Carbonella, NP-C

• Diagnostic Radiology Physician in Rochester, NH
• Providers in Rochester, NH by specialty
• Diagnostic Radiology Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.