Active NPI
Shannon Georgeann Wiggins, DO
- Family Medicine Physician
- Lansing, MI
National Provider Identifier
1295744530
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Dec 18, 2014.
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5101013727
- Practice address
- 2310 E Michigan Ave
Lansing, MI 48912-4018 - Phone
- (517) 346-7628
- Fax
- (517) 346-7629
- NPI assigned
- Aug 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101013727 | MI | Primary |
Addresses
Primary practice location
2310 E Michigan Ave
Lansing, MI 48912-4018
Mailing address
2310 E Michigan Ave
Lansing, MI 48912-4018
Phone (517) 346-7628
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0853310215 | Other | BCN | |
| 114546319 | Medicaid | MI | |
| 0853310215 | Other | MI | BLUE CROSS |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Provisions Health | Family Medicine | Current | Accepting new patients |
| East Michigan Family Care PLC | Family Medicine | Current | Accepting new patients |
Locations
2310 E Michigan Ave
Lansing, MI 48912
Phone (517) 346-7628
Organizations & group practices 2
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": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1295744530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2310 E MICHIGAN AVE",
"city": "LANSING",
"state": "MI",
"postal_code": "489124018",
"telephone_number": "517-346-7628",
"fax_number": "517-346-7629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2310 E MICHIGAN AVE",
"city": "LANSING",
"state": "MI",
"postal_code": "489124018",
"telephone_number": "517-346-7628",
"fax_number": "517-346-7629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIGGINS",
"first_name": "SHANNON",
"middle_name": "GEORGEANN",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-05",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5101013727",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCN",
"identifier": "0853310215",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "114546319",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "0853310215",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.