Individual provider Active NPI

Shannon Perkins

  • Nurse Practitioner
  • Mayfield Village, OH
National Provider Identifier
1104297381
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5008583 Issued in NC
Practice address
730 Som Center Rd
Suite Number 240
Mayfield Village, OH 44143-2350
Phone
(440) 720-3230
Fax
(216) 201-6433
NPI assigned
Oct 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5008583 NC Primary

Addresses

Primary practice location

730 Som Center Rd
Suite Number 240
Mayfield Village, OH 44143-2350

Mailing address

2301 Erwin Rd
Suite Number 240
Durham, NC 27705-4699
Phone (919) 660-6860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151030001523 OH Practitioner - Nurse Practitioner 4981914132 Reassigns benefits to 1 organization
I20171013001362 NY Practitioner - Nurse Practitioner 4981914132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8636

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5008583NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in CurrentSince Sep 7, 2017 Accepting new patients
Department of Medicine Medical Service Group CurrentSince Sep 7, 2017 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Jul 22, 2020 Accepting new patients

Locations

251 Salina Meadows Pkwy
Ste 100
Syracuse, NY 13212
Phone (315) 464-2000

1000 E Genesee St
Ste 403
Syracuse, NY 13210
Phone (315) 464-2929

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 3

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 2

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": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1104297381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 ERWIN RD",
            "address_2": "SUITE NUMBER 240",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054699",
            "telephone_number": "919-660-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 SOM CENTER RD",
            "address_2": "SUITE NUMBER 240",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441432350",
            "telephone_number": "440-720-3230",
            "fax_number": "216-201-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-13",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5008583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield Village, OH

Sources for this page

Verify at the official NPI Registry.