Individual provider Active NPI

Shannon Michelle Keil, MD

  • Anatomic Pathology Physician
  • Bryan, OH
National Provider Identifier
1487627220
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
35-087274 Issued in OH
Practice address
433 W High St
Bryan, OH 43506-1690
Phone
(419) 636-1131
Fax
(419) 636-3100
NPI assigned
Feb 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X ME178052 FL
Anatomic Pathology Physician 207ZP0101X 35-087274 OH Primary

Addresses

Primary practice location

433 W High St
Bryan, OH 43506-1690

Mailing address

433 W High St
Bryan, OH 43506-1690

Other identifiers 1

IdentifierTypeStateIssuer
N/AOtherN/A

Other names 1

  • Shannon Michelle Ellis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IN, FL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20060605000117 OH Practitioner - Pathology 5496766511 Reassigns benefits to 1 organization
I20231117001848 IN Practitioner - Pathology 5496766511 Reassigns benefits to 1 organization
I20260306000196 FL Practitioner - Pathology 5496766511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Medical College of Ohio, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Regional Laboratories Pathology Services, LLCGroup PAC ID 9133244346, 132 clinicians

Practice addresses (Care Compare)

21298 Olean Blvd
Port Charlotte, FL 33952-6705
Phone (941) 627-6128

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.59 of 100Reported as group
Quality
93.8
Improvement activities
40
Cost
79.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME178052FLMDAnatomic Pathology Physician
35-087274OHMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Cincinnati Pathologists, Inc Anatomic Pathology & Clinical Pathology CurrentSince Aug 28, 2023 Accepting new patients
Integrated Regional Laboratories Pathology Services, LLC Anatomic Pathology & Clinical Pathology CurrentSince Apr 6, 2026 Accepting new patients

Locations

2020 59th St W
Bradenton, FL 34209
Phone (813) 798-6303

21298 Olean Blvd
Pt Charlotte, FL 33952
Phone (941) 624-7032

321 Mitchell Ave
Batesville, IN 47006
Phone (812) 933-5018

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

2139 Auburn Ave
Cincinnati, OH 45219
Phone (513) 585-0406

Organizations & group practices 2

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 1

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1487627220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 W HIGH ST",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 W HIGH ST",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061690",
            "telephone_number": "419-636-1131",
            "fax_number": "419-636-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIL",
        "first_name": "SHANNON",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "FL",
            "license": "ME178052",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "OH",
            "license": "35-087274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "N/A",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "ELLIS",
            "middle_name": "MICHELLE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bryan, OH

Sources for this page

Verify at the official NPI Registry.