Individual provider Active NPI

Shannon Leonard, DO

  • Obstetrics & Gynecology Physician
  • Wynnewood, PA
National Provider Identifier
1114717360
Registry record updated May 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
OT024436 Issued in PA
Practice address
100 E Lancaster Ave
Wynnewood, PA 19096-3450
Phone
(484) 476-4650
NPI assigned
May 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X OT024436 PA Primary

Addresses

Primary practice location

100 E Lancaster Ave
Wynnewood, PA 19096-3450

Mailing address

100 E Lancaster Ave
Wynnewood, PA 19096-3450
Phone (484) 476-4650

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20251126004464 PA Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 5799277679

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OT024436PAMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1746835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746835200000",
    "number": "1114717360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-10",
        "last_updated": "2025-05-10",
        "certification_date": "2025-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "OT024436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.