Active NPI
Michael Caroll Shannon, MD
- Pediatric Critical Care Medicine Physician
- Seattle, WA
National Provider Identifier
1164531497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- MD60096471
- Practice address
- 1101 Madison St Ste 800
Swedish Pediatric Specialty Care
Seattle, WA 98104-1307 - Phone
- (206) 215-2700
- Fax
- (206) 215-2702
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | MD60096471 | WA | Primary |
Addresses
Primary practice location
1101 Madison St Ste 800
Swedish Pediatric Specialty Care
Seattle, WA 98104-1307
Mailing address
1101 Madison St Ste 800
Swedish Pediatric Specialty Care
Seattle, WA 98104-1307
Phone (206) 215-2700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8549958 | Medicaid | WA | |
| L6647 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD60096471 | WA | MD | Pediatric Critical Care Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swedish Health Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Seattle, WA
- NPI 1306992151
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377475200000",
"number": "1164531497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 MADISON ST STE 800",
"address_2": "SWEDISH PEDIATRIC SPECIALTY CARE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981041307",
"telephone_number": "206-215-2700",
"fax_number": "206-215-2702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 MADISON ST STE 800",
"address_2": "SWEDISH PEDIATRIC SPECIALTY CARE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981041307",
"telephone_number": "206-215-2700",
"fax_number": "206-215-2702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANNON",
"first_name": "MICHAEL",
"middle_name": "CAROLL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2013-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "WA",
"license": "MD60096471",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8549958",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "L6647",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.