Active NPI
Claude K Shannon, M.D.
- Family Medicine Physician
- Morgantown, WV
National Provider Identifier
1073625521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 12342
- Practice address
- 1 Medical Center Drive
Morgantown, WV 26506 - Phone
- (304) 598-6900
- Fax
- (304) 598-6914
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 12342 | WV | Primary |
Addresses
Primary practice location
1 Medical Center Drive
Morgantown, WV 26506
Mailing address
P. O. Box 897
Morgantown, WV 26507-0897
Phone (304) 293-7401
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0007709000 | Medicaid | WV | |
| 0056507000 | Medicaid | WV | |
| CA9811 | Other | WV | MEDICARE RAILROAD CARRIER |
| SH0506016 | Other | WV | PMMG MEDICARE ID |
| PR9255725 | Other | WV | MEDICARE GROUP NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160520002038 | WV | Order and Referring Only - Family Practice | 6305817065 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287705600000",
"number": "1073625521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P. O. BOX 897",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265070897",
"telephone_number": "304-293-7401",
"fax_number": "304-293-6963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DRIVE",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "26506",
"telephone_number": "304-598-6900",
"fax_number": "304-598-6914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANNON",
"first_name": "CLAUDE",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2010-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WV",
"license": "12342",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0007709000",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0056507000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD CARRIER",
"identifier": "CA9811",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PMMG MEDICARE ID",
"identifier": "SH0506016",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NUMBER",
"identifier": "PR9255725",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Morgantown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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.