Individual provider Active NPI

Shannon Marie Matthews, MD

  • Emergency Medicine Physician
  • Raleigh, NC
National Provider Identifier
1427494152
Registry record updated Apr 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2015-00242 Issued in NC
Practice address
3000 New Bern Ave
Raleigh, NC 27610-1295
Phone
(919) 350-8000
NPI assigned
May 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 2015-00242 NC Primary

Addresses

Primary practice location

3000 New Bern Ave
Raleigh, NC 27610-1295

Mailing address

210 Towne Village Dr
Cary, NC 27513-8910
Phone (919) 859-3373

Other practice location 1

170 Manning Dr
Department of Emergency Medicine
Chapel Hill, NC 27514-4221
Phone (919) 966-6440

Other names 1

  • Shannon Marie Spano Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150810001046 NC Practitioner - Emergency Medicine 0244544930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Emergency Physicians PAGroup PAC ID 9931002078, 269 clinicians

Practice addresses (Care Compare)

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.58 of 100Reported as group
Quality
75.66
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2015-00242NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Emergency Physicians PA Single Specialty CurrentSince Jul 1, 2015 Accepting new patients
Wake Emergency Physicians PA Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients
Wake Emergency Physicians PA Single Specialty Current Accepting new patients
Wake Emergency Physicians PA Emergency Medicine Past Accepting new patients

Locations

210 Towne Village Dr
Cary, NC 27513
Phone (919) 348-4483

1900 Kildaire Farm Rd
Cary, NC 27518
Phone (919) 350-2300

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

Interoperability endpoints

  • Direct secure messaging: smatthews14916@directhisp.wakemed.org

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555113600000",
    "number": "1427494152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 TOWNE VILLAGE DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138910",
            "telephone_number": "919-859-3373",
            "fax_number": "919-859-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101295",
            "telephone_number": "919-350-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 Manning Dr",
            "address_2": "Department of Emergency Medicine",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275144221",
            "country_code": "US",
            "telephone_number": "919-966-6440",
            "fax_number": "919-966-3049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2019-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2015-00242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "SPANO",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.