Shannon Elizabeth Jackman Cowcer

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1205 McFadden Dr
East Northport, NY 11731-2721

Phone

(631) 375-5378

NPI assigned

Apr 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1710620745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 MCFADDEN DR",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117312721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 MCFADDEN DR",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117312721",
            "telephone_number": "631-375-5378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWCER",
        "first_name": "SHANNON",
        "middle_name": "ELIZABETH JACKMAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-18",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judy Nan Cooper, LCSW
• Amy L Coopersmith, MS, OTR/L
• Maria Cortese, LMT
• Juliet Costa
• Nicole Alison Costello, PHARMD
• Jennifer Marie Creter, LPN
• Michael Cromer
• Nicole Cuoccio, DMD
• Sesil Curiale
• Jeffrey J. Cusack, D.P.M.

• Student in an Organized Health Care Education/Training Program in East Northport, NY
• Providers in East Northport, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.