Shannon Bowen

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301119017 Issued in MI

Practice address

4401 Campus Ridge Dr Ste 2200
Midland, MI 48640

Phone

(989) 837-9250

NPI assigned

Aug 2, 2016

Sex

Female

Sole proprietor

No

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 MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sbowen83663@mymichiganhealth.midirect.net

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.

• Mymichigan Medical Center Midland

  • Multi-Specialty Clinic/Center
  • Midland, MI
  • NPI 1205889490
  Medicare reassignment NPD
• Mymichigan Medical Center Midland

  • Anesthesiology Physician
  • Midland, MI
  • NPI 1649010455
  NPD
• Mymichigan Medical Center West Branch

  • General Acute Care Hospital
  • West Branch, MI
  • NPI 1538566765
  NPD (past)

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1093268468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 CAMPUS RIDGE DR STE 2200",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406127",
            "telephone_number": "989-837-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 CAMPUS RIDGE DR STE 2200",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "48640",
            "telephone_number": "989-837-9250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "One Hurley Plaza, 3D West",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "48503",
            "country_code": "US",
            "telephone_number": "810-262-6046",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "One Hurley Plaza, 3D West",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "48503",
            "country_code": "US",
            "telephone_number": "810-262-6046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301109762",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301119017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William C Boss, DMD
• Caitlyn Louise Bott
• Racha W Boulos, MD
• Nicole L Bourlakas-Maurer, LMSW, CBIS
• Stacie Kay Bovee, LMSW
• Korrin Brady
• Karrie Ann Bragiel, RPH
• Trisha Brandel
• Theresa Brannon
• Nicole Braun, M.A., CCC-SLP

• Pediatrics Physician in Midland, MI
• Providers in Midland, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; 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.