Active NPI
Denise Shannon, LICSW
- Social Worker
- Saint Paul, MN
National Provider Identifier
1184174898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 9304
- Practice address
- 640 Jackson St
Saint Paul, MN 55101-2502 - Phone
- (651) 254-3448
- Fax
- (651) 254-3470
- NPI assigned
- Oct 5, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 9304 | MN | Primary |
Addresses
Primary practice location
640 Jackson St
Saint Paul, MN 55101-2502
Mailing address
8170 33Rd Ave S # Ms 21110Q
Minneapolis, MN 55425-4516
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-3456
8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148
Hospital & facility affiliations
- Regions Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9304 | MN | MD | Neonatal Nurse Practitioner |
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.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1710924683
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Woodbury, MN
- NPI 1104681105
-
- General Acute Care Hospital
- Saint Paul, MN
- NPI 1306873872
-
- General Acute Care Hospital
- Saint Paul, MN
- NPI 1629006457
-
- General Acute Care Hospital
- Stillwater, MN
- NPI 1679391122
-
- General Acute Care Hospital
- Coon Rapids, MN
- NPI 1962149419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616025600000",
"number": "1184174898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE S # MS 21110Q",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554254516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 JACKSON ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551012502",
"telephone_number": "651-254-3448",
"fax_number": "651-254-3470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANNON",
"first_name": "DENISE",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-05",
"last_updated": "2021-03-18",
"certification_date": "2021-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MN",
"license": "9304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.