Shannon Gerow, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704353282 Issued in MI

Practice address

3124 N Wellness Dr Ste 10
Holland, MI 49424-8121

Phone

(616) 738-5870

NPI assigned

Feb 18, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Lakeshore Plastic and Reconstructive Surgery Associates, P.C.

  • Plastic Surgery Physician
  • Holland, MI
  • NPI 1467641373
  NPD

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1407489586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 N WELLNESS DR STE 10",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248121",
            "telephone_number": "616-738-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 N WELLNESS DR STE 10",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248121",
            "telephone_number": "616-738-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEROW",
        "first_name": "SHANNON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704353282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4704353282",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "616-738-5872",
            "affiliation": "N",
            "endpointDescription": "fax machine",
            "address_1": "3124 N Wellness Dr Ste 10",
            "city": "Holland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494248121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cameron Haslam George, D.D.S. M. S
• Daniel C. George, D.D.S.
• James W Gerard, M.D.
• Laura Christine Gerencer, FNP-BC
• William Germain, PHARMACIST
• Jenna Gerrits
• Kayla Gethin
• Emily Amila Geurink, AT, ATC, PTA
• Evie Ellen Geurink, PHARMD
• Timothy Mark Gezon, MD

• Nurse Practitioner in Holland, MI
• Providers in Holland, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; 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.