Active NPI
Stephen Patrick Shannon, DDS
- Dentist
- Baton Rouge, LA
National Provider Identifier
1467650598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5278
- Practice address
- 13360 Coursey Blvd
Suite C
Baton Rouge, LA 70816 - Phone
- (225) 752-8348
- NPI assigned
- Jul 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5278 | LA | Primary |
Addresses
Primary practice location
13360 Coursey Blvd
Suite C
Baton Rouge, LA 70816
Mailing address
13360 Coursey Blvd
Suite C
Baton Rouge, LA 70816
Phone (225) 752-8348
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5278 | LA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184025600000",
"number": "1467650598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13360 COURSEY BLVD",
"address_2": "SUITE C",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "70816",
"telephone_number": "225-752-8348",
"fax_number": "225-752-8352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13360 COURSEY BLVD",
"address_2": "SUITE C",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "70816",
"telephone_number": "225-752-8348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANNON",
"first_name": "STEPHEN",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-10",
"last_updated": "2007-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "5278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.