Shannon Marie Killeen, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

01100290A Issued in IN

Practice address

3050 N Lintel Dr
Bloomington, IN 47404-8945

Phone

(812) 336-2815

NPI assigned

Apr 5, 2022

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

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Directed Rehabilitation Services

  • Physical Medicine & Rehabilitation Physician
  • Noblesville, IN
  • NPI 1063037398
  NPD

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1174264998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 N LINTEL DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474048945",
            "telephone_number": "812-336-2815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 N LINTEL DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474048945",
            "telephone_number": "812-336-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLEEN",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "01100290A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kids Play Sensory Gym LLC (Kids Play Gym)
• John David Kiesel, DPT
• Nicole Evonne Kieser, PMHNP-BC
• Carolyn Yandura Kilar, M.A.,CCC-SLP
• Heather Elizabeth Kill, CNM
• Melissa Kilpatrick, LCSW
• Jooho Peter Kim, MD
• Kwang Jun Kim, MD
• Stacey Kim, LSW
• Samuel W Kimani, MD

• Physical Medicine & Rehabilitation Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Physical Medicine & Rehabilitation Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.