Shannon M Anderson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1499 6TH St
Green Bay, WI 54304-2252

Phone

(920) 497-6161

Fax

(888) 974-5769

NPI assigned

Jun 27, 2022

Last updated

Jun 27, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Innovative Counseling IncGroup PAC ID 8022154749, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Innovative Counseling Inc

  • Community/Behavioral Health Agency
  • Green Bay, WI
  • NPI 1093869588
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1053043398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 6TH ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543042252",
            "telephone_number": "920-497-6161",
            "fax_number": "888-974-5769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 6TH ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543042252",
            "telephone_number": "920-497-6161",
            "fax_number": "888-974-5769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SHANNON",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert James Anderson, MD
• Sara Ann Anderson
• Sara L Anderson, NNP-BC, APNP
• Sara Lynn Anderson, M.D.
• Sarah Lynn Anderson, DPT
• Andrea Labine, PH.D LLC
• Joao Vitor Andreoli Saltao, MD
• Todd Matthew Andres, OT
• Andresource, LLC
• John Frederick Andrews, MD

• Clinical Social Worker in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.