Active NPI
Shannon B Wilson, M.D.
- Diagnostic Radiology Physician
- Norfolk, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 0101267058
- Practice address
- 600 Gresham Dr
Norfolk, VA 23507-1904 - Phone
- (757) 388-1141
- Fax
- (757) 388-1145
- NPI assigned
- Mar 28, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Diagnostic Radiology Physician | 2085R0202X | 0101267058 | VA | Primary |
Addresses
Primary practice location
600 Gresham Dr
Norfolk, VA 23507-1904
Mailing address
PO Box 1980
Norfolk, VA 23501-1980
Phone (757) 388-1141
Other names 1
- Dr. Shannon B Kim
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Eastern Virginia Medical School, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5544 Greenwich Rd
Suite 200
Virginia Beach, VA 23462-6563
Phone (757) 466-0089
Hospital & facility affiliations
- Sentara Careplex Hospital
- Sentara Williamsburg Regional Medical Center
- Sentara Norfolk General Hospital
- Sentara Leigh Hospital
- Bon Secours Maryview Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.94 of 100
- Quality
- 91.31
- Improvement activities
- 40
- Cost
- 79.05
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101267058 | VA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Center Radiologists Inc | Diagnostic Radiology | Current | Accepting new patients |
Locations
600 Gresham Dr
Ste 700
Norfolk, VA 23507
Phone (757) 388-1700
600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055
601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272
830 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-6000
3636 High St
Portsmouth, VA 23707
Phone (757) 398-2200
5818 Harbour View Blvd
Suffolk, VA 23435
Phone (757) 673-5800
800 Independence Blvd
Virginia Beach, VA 23455
Phone (757) 363-6100
5544 Greenwich Rd
Ste 200
Virginia Beach, VA 23462
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.
-
- Diagnostic Radiology Physician
- Norfolk, VA
- NPI 1720079254
Hospital & facility affiliations 14
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portsmouth, VA
- NPI 1750399192
-
- General Acute Care Hospital
- Hampton, VA
- NPI 1336109107
-
- General Acute Care Hospital
- Norfolk, VA
- NPI 1437119310
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588896000000",
"number": "1326465220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1980",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235011980",
"telephone_number": "757-388-1141",
"fax_number": "757-388-1145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 GRESHAM DR",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235071904",
"telephone_number": "757-388-1141",
"fax_number": "757-388-1145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SHANNON",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-28",
"last_updated": "2020-05-08",
"certification_date": "2020-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "VA",
"license": "0101267058",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHANNON",
"last_name": "KIM",
"middle_name": "B",
"prefix": "DR.",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2020; 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.