Individual provider Active NPI

Shannon M. Carruthers, M.D.

  • Pediatrics Physician
  • Sioux Falls, SD
National Provider Identifier
1437438611
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
#9303 Issued in SD
Practice address
4405 E. 26TH St.
Sioux Falls, SD 57103
Phone
(605) 328-9080
NPI assigned
Aug 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301099364 MI
Pediatrics Physician 208000000X #9303 SD Primary

Addresses

Primary practice location

4405 E. 26TH St.
Sioux Falls, SD 57103

Mailing address

4405 E. 26TH St.
Sioux Falls, SD 57103
Phone (605) 328-9080

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sashbaugh5681311@direct.sanfordhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20141223000040 SD Practitioner - Pediatric Medicine 6901129048 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301099364MIMDPediatrics Physician
#9303SDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center CurrentSince Oct 27, 2014 Accepting new patients
Sanford Clinic Current Accepting new patients
Sanford Clinic CurrentSince Oct 27, 2014 Accepting new patients
Sanford Clinic CurrentSince Oct 27, 2014 Accepting new patients

Locations

111 N Cliff Ave
Harrisburg, SD 57032
Phone (605) 213-7900

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

Interoperability endpoints

  • Direct secure messaging: sashbaugh5681311@direct.sanfordhealth.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.

NPI Registry JSON

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

{
    "created_epoch": "1312502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1437438611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 E. 26TH ST.",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "57103",
            "telephone_number": "605-328-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 E. 26TH ST.",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "57103",
            "telephone_number": "605-328-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRUTHERS",
        "first_name": "SHANNON",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-05",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301099364",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SD",
            "license": "#9303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sashbaugh5681311@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "4405 E. 26th St.",
            "city": "Sioux Falls",
            "state": "SD",
            "country_code": "US",
            "postal_code": "57103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.