Shannon Medical Center

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

APPLIED FOR Issued in TX

Legal business name

SHANNON MEDICAL CENTER

Doing business as

Shannon Dialysis Services - Brady

Practice address

2008 Nine Rd
Brady, TX 76825-7210

Phone

(325) 597-2901

NPI assigned

Mar 5, 2013

Last updated

Mar 5, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

SHANNON MEDICAL CENTERAs reported in NPPES

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

Authorized official

Name

Bryan Horner

Title

Ceo

Phone

(325) 657-8266

Specialties & licenses 1

Addresses

Other names 1

• Shannon Dialysis Services - Brady Doing business as

Part of

Family Health Ctr del R

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

{
    "created_epoch": "1362441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362441600000",
    "number": "1699016337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E HARRIS AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 NINE RD",
            "city": "BRADY",
            "state": "TX",
            "postal_code": "768257210",
            "telephone_number": "325-597-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHANNON MEDICAL CENTER",
        "enumeration_date": "2013-03-05",
        "last_updated": "2013-03-05",
        "status": "A",
        "authorized_official_last_name": "HORNER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "325-657-8266"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": "APPLIED FOR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shannon Dialysis Services - Brady",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Harper Neal Price, FNP
• Deborah Christine Probst, PHD
• Dorothy Lee Richardson
• Royal Oaks Assisted Living
• Rubye B Lewallen (Lewallen Home)
• Southwest LTC--Brady West, LTD. (Brady West Nursing and Convalescent Center)
• Krissie Ann Springer
• Chelsea Spurgin, RN
• Stephen F. Defiore, D.C., P.a. (Brady Chiropractic Clinic)
• Rita Nobles Sutton, P.T.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Brady, TX
• Providers in Brady, TX by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; 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.