Shannon D. Edwards, M.D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

E-6936 Issued in AR

Practice address

2710 Rife Medical LN
Rogers, AR 72758-1452

Phone

(479) 338-8000

Fax

(479) 338-2906

NPI assigned

May 21, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shannon D. Koeneman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1457518821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 RIFE MEDICAL LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-338-8000",
            "fax_number": "479-338-2906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 RIFE MEDICAL LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-338-8000",
            "fax_number": "479-338-2906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "SHANNON",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AR",
            "license": "E-6936",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-6936",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "KOENEMAN",
            "middle_name": "D.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Larry C Eddy, DDS
• Eden Birth and Wellness
• Kathryn A Edgar
• Regena Stacy Edster, LPC
• Marjorie Antenor Edwards, M.D.
• Ehc MJP Inc
• Mildred A Ehrhart, DO
• Noah John Eichelberger, OD
• Amanda Marie Eichholz, PA
• Kurt Power Eifling, M.D.

• Hospitalist Physician in Rogers, AR
• Providers in Rogers, AR by specialty
• Hospitalist Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.