Individual provider Active NPI

Shannon McDuff Johnson, MD

  • Internal Medicine Physician
  • Canton, MI
National Provider Identifier
1164048401
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301509709 Issued in MI
Practice address
1051 N Canton Center Rd
Canton, MI 48187-5097
Phone
(734) 998-2020
NPI assigned
Jun 23, 2020
Last updated
Aug 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301509709 MI Primary

Addresses

Primary practice location

1051 N Canton Center Rd
Canton, MI 48187-5097

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230824002413 MI Practitioner - Internal Medicine 1355766908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1051 N Canton CNTR Rd
University of Michigan Med Peds Association
Ann Arbor, MI 48187-5097
Phone (734) 844-5400

1051 N Canton Ctr
Canton, MI 48187-5097
Phone (734) 844-5390

1051 N Canton Ctr Rd
Canton, MI 48187-5097

1500 E Medical Ctr
Suite 0331
Ann Arbor, MI 48109-0999
Phone (734) 936-5738

1500 E Medical Ctr 2ND Floor Rec
Taubman Center
Ann Arbor, MI 48109-0999
Phone (734) 936-5020

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-0999

1500 E Medical Ctr Dr 1St Flo
Ann Arbor, MI 48109-0999

1500 E Medical Ctr Dr 1St Floor
Ann Arbor, MI 48109-0999

1500 E Medical Ctr Dr 2ND LR
Med Inn
Ann Arbor, MI 48109-0999
Phone (734) 763-5459

1500 E Medical Ctr Dr B2 Floor R
Cancer and Geriatrics Center
Ann Arbor, MI 48109-0999
Phone (734) 936-6274

1500 E Medical Ctr Dr Level B
Cancer and Geriatrics Center
Ann Arbor, MI 48109-0999
Phone (734) 647-8901

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Internal Medicine Current Accepting new patients
Regents of the University of Michigan Internal Medicine CurrentSince Jul 25, 2023 Accepting new patients
Regents of the University of Michigan CurrentSince Jul 25, 2023 Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1051 N Canton Center Rd
Canton, MI 48187
Phone (734) 647-5670

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1164048401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 N CANTON CENTER RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481875097",
            "telephone_number": "734-998-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHANNON",
        "middle_name": "MCDUFF",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-23",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301509709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.