Jean R Shannon

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1849-19 Issued in WI

Practice address

19010 93Rd St
Bristol, WI 53104-9611

Phone

(262) 891-3359

NPI assigned

Sep 24, 2024

Last updated

Sep 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1508683103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19010 93RD ST",
            "city": "BRISTOL",
            "state": "WI",
            "postal_code": "531049611",
            "telephone_number": "262-891-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19010 93RD ST",
            "city": "BRISTOL",
            "state": "WI",
            "postal_code": "531049611",
            "telephone_number": "262-891-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "JEAN",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "1849-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whittney Koepnick, BSN, RN
• Kristin M Keeler, S.C
• Megan May, M.S.
• Erika McCullough, LPN
• Dennette L. Scheckel, MHS, CCC/SLP/L
• Town of Bristol
• United Hospital System
• Village of Bristol
• Nikki E Williams, LPN

• Occupational Therapist in Bristol, WI
• Providers in Bristol, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.