Individual provider Active NPI

Shannon Fisher, PA-C

  • Physician Assistant
  • Grant, NE
National Provider Identifier
1083252530
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2470 Issued in NE
Practice address
912 Central Ave
Grant, NE 69140-3099
Phone
(308) 352-7100
Fax
(308) 352-7103
NPI assigned
Dec 16, 2019
Last updated
Dec 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2470 NE Primary

Addresses

Primary practice location

912 Central Ave
Grant, NE 69140-3099

Mailing address

912 Central Ave
Grant, NE 69140-3099
Phone (308) 352-7100

Other names 1

  • Shannon Liewer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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

Enrollment IDStateProvider typePAC IDDetails
I20200325000554 NE Practitioner - Physician Assistant 7113355132 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perkins County Hospital DistrictGroup PAC ID 0840109823, 22 clinicians

Practice addresses (Care Compare)

912 Central Ave
Grant, NE 69140-3099
Phone (308) 352-7100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
31.28 of 100Reported as group
Quality
19.15
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2470NEMDAerospace Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Perkins County Hospital District Current Accepting new patients
Perkins County Hospital District CurrentSince Mar 3, 2020 Accepting new patients
Perkins County Hospital District Past Accepting new patients

Locations

900 Lincoln Ave
Grant, NE 69140
Phone (308) 352-7200

912 Central Ave
Grant, NE 69140
Phone (308) 352-7100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1083252530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 CENTRAL AVE",
            "city": "GRANT",
            "state": "NE",
            "postal_code": "691403099",
            "telephone_number": "308-352-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 CENTRAL AVE",
            "city": "GRANT",
            "state": "NE",
            "postal_code": "691403099",
            "telephone_number": "308-352-7100",
            "fax_number": "308-352-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "SHANNON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-16",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "LIEWER",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grant, NE

Sources for this page

Verify at the official NPI Registry.