Individual provider Active NPI

Kerry Lee Shannon, MD, DRPH, MPH

  • Emergency Medicine Physician
  • Baltimore, MD
National Provider Identifier
1013211317
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D89056 Issued in MD
Practice address
The Johns Hopkins Hospital
1830 E. Monument St, Suite 6-100
Baltimore, MD 21287-0005
Phone
(410) 955-5000
NPI assigned
Dec 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D89056 MD Primary

Addresses

Primary practice location

The Johns Hopkins Hospital
1830 E. Monument St, Suite 6-100
Baltimore, MD 21287-0005

Mailing address

The Johns Hopkins Hospital
1830 E. Monument St, Suite 6-100
Baltimore, MD 21287-0005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, OR2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20200618002626 MD Practitioner - Emergency Medicine 2961770276 Reassigns benefits to 1 organization
I20211018002438 OR Practitioner - Emergency Medicine 2961770276 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Johns Hopkins University CurrentSince Jul 1, 2020 Accepting new patients
Peacehealth CurrentSince Sep 27, 2021 Accepting new patients
Johns Hopkins University Current Accepting new patients

Locations

4940 Eastern Ave
Baltimore, MD 21224

400 9th St
Florence, OR 97439
Phone (541) 997-8412

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

Interoperability endpoints

  • Direct secure messaging: kshannon532367@direct.peacehealth.org

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1293580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1013211317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "THE JOHNS HOPKINS HOSPITAL",
            "address_2": "1830 E. MONUMENT ST, SUITE 6-100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THE JOHNS HOPKINS HOSPITAL",
            "address_2": "1830 E. MONUMENT ST, SUITE 6-100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-955-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "KERRY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD, DRPH, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-29",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D89056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.