Provider Demographics
NPI:1699842799
Name:JARMER, SHANA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHANA
Middle Name:
Last Name:JARMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 E 16TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67152-2828
Mailing Address - Country:US
Mailing Address - Phone:620-326-3301
Mailing Address - Fax:
Practice Address - Street 1:507 E 16TH ST STE 1
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-2828
Practice Address - Country:US
Practice Address - Phone:620-326-3301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0431417207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
106743OtherBCBS OF KANSAS
KS1255500633OtherNON RHC NPI CLINIC
15575OtherPREFERRED PLUS OF KANSAS
281367802OtherUNITED HEALTH CARE
324285OtherCOVENTRY
792977001OtherCIGNA
KSP00890504OtherMEDICARE RAILROAD PTAN
1437283991OtherGROUP NPI
KS200371170CMedicaid
KS0431417OtherLICENSE
9593105OtherAETNA
CS5682OtherRAILROAD MEDICARE
CS5682OtherRAILROAD MEDICARE