Active NPI
Shannon B Palmer, AUD, PHD
- Audiologist
- Mt Pleasant, MI
National Provider Identifier
1023395886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 1601000601
- Practice address
- 1101 Health Professions BRG
Mt Pleasant, MI 48859-0001 - Phone
- (989) 774-3904
- Fax
- (989) 774-1891
- NPI assigned
- Nov 8, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 1601000601 | MI | Primary |
Addresses
Primary practice location
1101 Health Professions BRG
Mt Pleasant, MI 48859-0001
Mailing address
1101 Health Professions BRG
Mt Pleasant, MI 48859-0001
Phone (989) 774-3904
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1601000601 | Other | MI | STATE LICENSE |
| 14030014 | Other | MI | ASHA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1601000601 | MI | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Michigan University | Current | Accepting new patients |
Locations
1101 Health Professions
Mount Pleasant, MI 48859
Phone (989) 774-2597
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Mt Pleasant, MI
- NPI 1487686754
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320710400000",
"number": "1023395886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 HEALTH PROFESSIONS BRG",
"city": "MT PLEASANT",
"state": "MI",
"postal_code": "488590001",
"telephone_number": "989-774-3904",
"fax_number": "989-774-1891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 HEALTH PROFESSIONS BRG",
"city": "MT PLEASANT",
"state": "MI",
"postal_code": "488590001",
"telephone_number": "989-774-3904",
"fax_number": "989-774-1891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "SHANNON",
"middle_name": "B",
"credential": "AUD, PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-08",
"last_updated": "2011-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MI",
"license": "1601000601",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "1601000601",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHA",
"identifier": "14030014",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mt Pleasant, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.