Individual provider Active NPI

Shannon L Yow

  • Nurse Practitioner
  • Pleasant Prairie, WI
National Provider Identifier
1093292625
Registry record updated Dec 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8557-33 Issued in WI
Practice address
9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone
(414) 290-6720
Fax
(414) 290-6755
NPI assigned
Jul 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1783549-30 WI
Nurse Practitioner 363L00000X 8557-33 WI Primary

Addresses

Primary practice location

9555 76TH St
Pleasant Prairie, WI 53158-1984

Mailing address

111 E Wisconsin Ave Ste 2000
Milwaukee, WI 53202-4809
Phone (414) 290-6720

Other practice location 1

6308 8th Ave
Kenosha, WI 53143-5031
Phone (414) 290-6720

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address syow347607@direct.froedtert.com Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181003000657 WI Practitioner - Nurse Practitioner 1759633712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Froedtert South IncGroup PAC ID 9537071196, 158 clinicians

Practice addresses (Care Compare)

10256 Old Green Bay Rd
Pleasant Prairie, WI 53158-2814
Phone (262) 551-4200

6308 8TH Ave
Kenosha, WI 53143-5031
Phone (262) 771-0073

9697 Saint Catherines Dr
Pleasant Prairie, WI 53158-2118
Phone (262) 656-3590

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
69.39
Promoting interoperability
100
Improvement activities
40
Cost
74.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8557WIMDOccupational Therapist
1783549-30WIMDNurse Practitioner
8557-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert South, Inc. CurrentSince Jan 2, 2023 Accepting new patients
Froedtert South, Inc. Past Accepting new patients

Locations

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

10256 Old Green Bay Rd
Fl 4
Kenosha, WI 53158
Phone (262) 551-4210

9697 Saint Catherines Dr
Pleasant Prairie, WI 53158
Phone (262) 577-8141

9697 Saint Catherines Dr
Ste 1200
Pleasant Prairie, WI 53158

9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000

Interoperability endpoints

  • Direct secure messaging: syow347607@direct.froedtert.com

Organizations & group practices 2

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.

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": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640476800000",
    "number": "1093292625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E WISCONSIN AVE STE 2000",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024809",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 76TH ST",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581984",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6308 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531435031",
            "country_code": "US",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOW",
        "first_name": "SHANNON",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2021-12-26",
        "certification_date": "2021-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "1783549-30",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "8557-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "syow347607@direct.froedtert.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "6308 8th Ave",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531435031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

Verify at the official NPI Registry.