Shannon Roush, MA

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

514359 Issued in OK

Practice address

721 N Center Dr NW
Walker, MI 49544-8215

Phone

(616) 647-2590

Fax

(616) 647-2689

NPI assigned

Nov 10, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Hope Network Behavioral Health Services

  • Mental Illness Community Based Residential Treatment Facility
  • Nunica, MI
  • NPI 1043295934
  NPD (past)

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1134525769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 N CENTER DR NW",
            "city": "WALKER",
            "state": "MI",
            "postal_code": "495448215",
            "telephone_number": "616-647-2590",
            "fax_number": "616-647-2689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 N CENTER DR NW",
            "city": "WALKER",
            "state": "MI",
            "postal_code": "495448215",
            "telephone_number": "616-647-2590",
            "fax_number": "616-647-2689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSH",
        "first_name": "SHANNON",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-10",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OK",
            "license": "514359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bennett George Riddering, MD
• Mary Lee Ritsema
• Donita Ann Robards, RN
• Julia Robbins
• Jacob Rodriguez
• Elizabeth Ann Rudolph, LLP
• RX Optical Laboratories, Inc.
• RX Optical Laboratories, Inc.
• Rick David Saier, MD
• Beverly Joan Sankey, MD

• Case Manager/Care Coordinator in Walker, MI
• Providers in Walker, MI by specialty
• Case Manager/Care Coordinator in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.