Shannon Michelle Davis, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036164424 Issued in IL

Practice address

15303 S 94TH Ave Ste 110
Orland Park, IL 60462-3825

Phone

(800) 991-6117

Fax

(888) 812-8191

NPI assigned

Apr 6, 2007

Last updated

Feb 15, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IN, IL2 enrollments

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 2

Specialty

General Surgery

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illinois Uvc Medical PLLCGroup PAC ID 4486986122, 13 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.davis@uvvc.eclinicaldirectplus.com

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.

• Illinois Uvc Medical PLLC

  dba United Vein & Vascular Centers

  • Vascular Surgery Physician
  • Oak Lawn, IL
  • NPI 1689224719
  Medicare reassignment Care Compare group NPD
• St Elizabeth Medical Center, Inc

  dba St Elizabeth Dearborn

  • General Acute Care Hospital
  • Lawrenceburg, IN
  • NPI 1326142498

  Surgery

  Medicare reassignment NPD
• Henry County Memorial Hospital

  dba Alpha Home - A Waters Community

  • Skilled Nursing Facility
  • Indianapolis, IN
  • NPI 1376662395
  NPD
• Lakeshore Womens Health Specialists SC

  • Obstetrics & Gynecology Physician
  • Chicago, IL
  • NPI 1528094869
  NPD (past)
• Health Services Corporation of Southeastern Indiana

  • Prosthetic/Orthotic Supplier
  • Lawrenceburg, IN
  • NPI 1033417829
  NPD (past)

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739577600000",
    "number": "1215059506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 NORTHDALE BLVD STE 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241893",
            "telephone_number": "813-280-0705",
            "fax_number": "813-434-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15303 S 94TH AVE STE 110",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623825",
            "telephone_number": "800-991-6117",
            "fax_number": "888-812-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHANNON",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2025-02-15",
        "certification_date": "2025-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "34.015496",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "05142",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "02003690A",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036164424",
            "primary": true
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "IL",
            "license": "036164424",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100787770",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0470386",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200992420",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda C Davenport, PA-C
• Anthony Salcedo David
• Myel Kira Morta David
• Jennifer Davidson
• Erin Davis
• Terene Davis, COTA
• Nancy Dawkins, LCSW
• Sabrina Dawud, DMD
• Carolyn E. Day, OTR/L
• Paul Michael De Bustros

• Surgery Physician in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2025; 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.

Verify at the official NPI Registry.