Shannon Marie Scanlon, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2022008174 Issued in MI

Practice address

701 Pleasant St
Grand Ledge, MI 48837-1344

Phone

(254) 258-2584

NPI assigned

Aug 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology and Skin Surgery CenterGroup PAC ID 2668467838, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sscanlon@docsdermmi.emadirect.md

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.

• Dermatology & Skin Surgery Center

  • Specialist
  • Battle Creek, MI
  • NPI 1083649628
  Medicare reassignment Care Compare group NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  Nurse Practitioner

  Medicare reassignment NPD

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

• W.a. Foote Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MI
  • NPI 1053403402
  Care Compare affiliation

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1104545292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PLEASANT ST",
            "city": "GRAND LEDGE",
            "state": "MI",
            "postal_code": "488371344",
            "telephone_number": "254-258-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PLEASANT ST",
            "city": "GRAND LEDGE",
            "state": "MI",
            "postal_code": "488371344",
            "telephone_number": "254-258-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANLON",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "2022008174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY NURSE PRACTITIONER CERTIFICATION",
            "identifier": "2022008174",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robyn D Messing DO PLLC
• Kyle Rodewald, PHARM.D.
• Amy Kathleen Rumsey, NP-C
• Maurice Leon Samuels
• Barbara D Saxena, MD
• Douglas Gerard Schaefer, L.P.T.A.
• Shelby Schefke
• Schmitzer Eyecare, P.C.
• Andrew H. Schmitzer, O.D.
• Tina Schrump

• Family Nurse Practitioner in Grand Ledge, MI
• Providers in Grand Ledge, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.