Angela B. Shannon, M.D.

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

22009 Issued in MS

Practice address

1679 Old Fannin Rd Ste E
Flowood, MS 39232-8101

Phone

(601) 398-1949

Fax

(769) 216-3044

NPI assigned

May 25, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: giaashannon@directaddress.net

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1407067739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1679 OLD FANNIN RD STE E",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328101",
            "telephone_number": "601-398-1949",
            "fax_number": "769-216-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1679 OLD FANNIN RD STE E",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328101",
            "telephone_number": "601-398-1949",
            "fax_number": "769-216-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "ANGELA",
        "middle_name": "B.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MS",
            "license": "22009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05307227",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shonda Monique Sessoms, LPC
• Tatum Lee Severino I, DNP, FNP-C
• Karen B. Shackelford, MD
• Lillian Leigh Shank, FNP-BC
• Selina Shanks
• Ramin Shariati, MD
• Anna Clair Sharp, PMHNP-BC
• Miriam J. Shatley, M.D.
• Erica Shaw Wooten, PTA
• Brittany Shaw, APRN, FNP-BC

• Pediatric Gastroenterology Physician in Flowood, MS
• Providers in Flowood, MS by specialty
• Pediatric Gastroenterology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.