Papnez PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PAPNEZ PLLC

Doing business as

Loon Lake Primary Care

Practice address

1545 N Wixom Rd
Wixom, MI 48393-1411

Phone

(248) 833-6343

Fax

(248) 833-6343

NPI assigned

Apr 2, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Paul S Shabou, MDNPI 1346818846

Title

Owner

Phone

(248) 833-6343

Specialties & licenses 2

Addresses

Other names 1

• Loon Lake Primary Care Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul S Shabou, MD

  • Family Medicine Physician
  • Wixom, MI
  • NPI 1346818846
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1326890666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 N WIXOM RD",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483931411",
            "telephone_number": "248-833-6343",
            "fax_number": "248-833-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 N WIXOM RD",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483931411",
            "telephone_number": "248-833-6343",
            "fax_number": "248-833-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAPNEZ PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A",
        "authorized_official_last_name": "SHABOU",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-833-6343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Loon Lake Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Wixom, MI
• Providers in Wixom, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.