Shannon Bashor, ATC
Individual provider Active NPI Athletic Trainer · Whitewater, WI
NPI 1962908608 · NPPES record last updated Apr 2, 2018
Key facts
- NPI
- 1962908608
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 2007-39 (WI)
- Practice address
- 907 W Schwager Dr
Whitewater, WI 53190 - Phone
- (262) 472-1581
- NPI assigned
- Apr 2, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2007-39 | WI | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2007-39 | WI | Yes |
Addresses
Primary practice location
907 W Schwager Dr
Whitewater, WI 53190
Mailing address
227 Larkspur CT
Sun Prairie, WI 53590-3472
Other providers in Whitewater, WI
- Ability Connect LLC
- Sean P.L.P. Alwin
- Ann M. Welch
- Peggy Louise Anton
- Amy L Barth
- Kimberly Bavis
- Ali Benson
- Nathaniel Stuart Besch
- Ryatisima Tishara Blue
- Lesley Loraine Blum
All providers in Whitewater, WI · Athletic Trainer in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.