Individual provider Active NPI

Shannon Marie Wronkowicz, MD

  • Hospitalist Physician
  • Toledo, OH
National Provider Identifier
1164627279
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
35089683 Issued in OH
Practice address
3020 N McCord Rd Ste 100
Toledo, OH 43615-1701
Phone
(419) 517-7658
NPI assigned
Jun 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 35089683 OH Primary
Pediatrics Physician 208000000X 35089683 OH

Addresses

Primary practice location

3020 N McCord Rd Ste 100
Toledo, OH 43615-1701

Mailing address

3020 N McCord Rd Ste 100
Toledo, OH 43615-1701

Other practice location 1

2213 Cherry St
6th Floor
Toledo, OH 43608-2603
Phone (419) 251-4993

Other identifiers 1

IdentifierTypeStateIssuer
2758903MedicaidOH

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
I20101122000011 OH Practitioner - Pediatric MedicinePractitioner - Hospitalist 6901092642 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35089683OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Pediatric Specialists, LLC Pediatrics CurrentSince Feb 16, 2025 Accepting new patients
Nationwide Children'S Hospital Toledo, LLC Past Accepting new patients
Mercy Health - St Vincent Medical Center LLC Past Accepting new patients

Locations

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

3521 Briarfield Blvd
Maumee, OH 43537
Phone (419) 794-7259

3020 N McCord Rd
Toledo, OH 43615
Phone (419) 251-8013

3020 N McCord Rd
Ste 100
Toledo, OH 43615
Phone (419) 251-8013

2213 Cherry St
Toledo, OH 43608
Phone (419) 251-4283

2213 Cherry St
Fl 6
Toledo, OH 43608
Phone (419) 251-4993

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2229/brand/3/csg/621/fhir/r4
  • FHIR API: https://hkc.nationwidechildrens.org/FHIR/MYCHART/api/FHIR/R4
  • Direct secure messaging: swronkowicz27013@direct.bsmhealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1164627279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 N MCCORD RD STE 100",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 N MCCORD RD STE 100",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151701",
            "telephone_number": "419-517-7658"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2213 Cherry St",
            "address_2": "6th Floor",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436082603",
            "country_code": "US",
            "telephone_number": "419-251-4993",
            "fax_number": "419-251-5330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRONKOWICZ",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35089683",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35089683",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2758903",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.