Individual provider Active NPI

Shannon Campbell Trotter, D.O.

  • Family Medicine Physician
  • Springfield, OH
National Provider Identifier
1124231154
Registry record updated Sep 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.013026 Issued in OH
Practice address
30 W McCreight Ave
Suite 110
Springfield, OH 45504-1842
Phone
(937) 523-9880
Fax
(937) 523-9899
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 34.009495 OH
Family Medicine Physician 207Q00000X 34.013026 OH Primary

Addresses

Primary practice location

30 W McCreight Ave
Suite 110
Springfield, OH 45504-1842

Mailing address

5400 Frantz Rd
Ste 250
Dublin, OH 43016-6102
Phone (937) 523-9880

Other identifiers 1

IdentifierTypeStateIssuer
0052162MedicaidOH

Other names 1

  • Dr. Shannon Maureen Campbell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20110907001569 OH Practitioner - Dermatology 1254526478 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Ohio University, College of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatologists of Southwestern Ohio, LLCGroup PAC ID 7113973041, 116 clinicians

Practice addresses (Care Compare)

187 S Tuttle Rd
Springfield, OH 45505-1560
Phone (937) 901-9581

5300 Far Hills Ave
Dayton, OH 45429-2381
Phone (937) 433-7536

6365 Winchester Blvd
Suite a
Canal Winchester, OH 43110-2069
Phone (614) 524-4146

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision35
Removal of tissue1-10
Removal of skin lesions1079
Removal or shaving of skin growth33
Skin biopsy263

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatologists of Southwestern Ohio, LLC. Dermatology CurrentSince Nov 2, 2020 Accepting new patients
Ohiohealth Corporation CurrentSince Aug 22, 2017 Accepting new patients
Ohiohealth Corporation Family Medicine CurrentSince Aug 22, 2017 Accepting new patients
Sturdy Health, Inc. Family Medicine Past Accepting new patients

Locations

75 Hospital Dr
Ste 250
Athens, OH 45701
Phone (740) 566-4621

6365 Winchester Blvd
Ste A
Canal Winchester, OH 43110
Phone (614) 524-4146

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

3595 Olentangy River Rd
Columbus, OH 43214
Phone (614) 556-5456

Dept L3652
Columbus, OH 43260

7835 Paragon Rd
Dayton, OH 45459
Phone (937) 434-2351

5300 Far Hills Ave
Dayton, OH 45429
Phone (513) 433-7536

5400 Frantz Rd
Ste 250
Dublin, OH 43016
Phone (614) 544-6161

187 S Tuttle Rd
Springfield, OH 45505
Phone (937) 901-9581

Interoperability endpoints

  • Direct secure messaging: strotter@dermswohio.emadirect.md

Organizations & group practices 4

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505952000000",
    "number": "1124231154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 FRANTZ RD",
            "address_2": "STE 250",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430166102",
            "telephone_number": "937-523-9880",
            "fax_number": "937-523-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W MCCREIGHT AVE",
            "address_2": "SUITE 110",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455041842",
            "telephone_number": "937-523-9880",
            "fax_number": "937-523-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROTTER",
        "first_name": "SHANNON",
        "middle_name": "CAMPBELL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2017-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "34.009495",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.013026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0052162",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "CAMPBELL",
            "middle_name": "MAUREEN",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.