Shannon Walowski, MSN, APNP, AGPCNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

7131-33 Issued in WI

Practice address

830 N 109TH St Ste 1
Wauwatosa, WI 53226-3754

Phone

(414) 777-1811

Fax

(414) 777-1812

NPI assigned

Nov 26, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

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 and National Provider Directory roles.

• Milwaukee Internal Medicine Associates Inc

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1457531345
  Medicare reassignment NPD

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

{
    "created_epoch": "1480118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1073056909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 N 109TH ST",
            "address_2": "STE 1",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263754",
            "telephone_number": "414-777-1811",
            "fax_number": "414-777-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 N 109TH ST STE 1",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263754",
            "telephone_number": "414-777-1811",
            "fax_number": "414-777-1812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2405 Northwestern Ave",
            "address_2": "#LL30",
            "address_purpose": "LOCATION",
            "city": "Racine",
            "state": "WI",
            "postal_code": "534042534",
            "country_code": "US",
            "telephone_number": "262-260-8370",
            "fax_number": "262-260-8538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALOWSKI",
        "first_name": "SHANNON",
        "credential": "MSN, APNP, AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WI",
            "license": "7131-33",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7131-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanne A Walker Dupree, APNP
• Wall Family Chiropractic LLC
• Spencer Wall, DPT
• Ingrid Wallace, L.P.C., C.R.C.
• Jill Wallace
• Sean Patrick Walsh-Rynders
• Austin Thomas Walsh, PA-C
• Christopher John Walsh, MD
• Deontay Walsh
• John Patrick Walsh, MD

• Nurse Practitioner in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.