Frederick Brett Shannon, D.O.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

OS4993 Issued in FL

Practice address

15821 Hollyfern CT
Ft. Myers, FL 33908

Phone

(239) 432-5100

Fax

(239) 432-0629

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Pediatric Orthopedics of Southwest FL

  dba Pediatric Orthopedics of SW FL

  • Pediatric Orthopaedic Surgery Physician
  • Fort Myers, FL
  • NPI 1386786838
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1518971225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15880 SUMMERLIN RD",
            "address_2": "STE 300 PMB 322",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339089612",
            "telephone_number": "239-432-5100",
            "fax_number": "239-432-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15821 HOLLYFERN CT",
            "city": "FT. MYERS",
            "state": "FL",
            "postal_code": "33908",
            "telephone_number": "239-432-5100",
            "fax_number": "239-432-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "FREDERICK",
        "middle_name": "BRETT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "OS4993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372036500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2017372-007",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4283415",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "80729",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "207270",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "195066",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAYWELL HEALTHY KIDS",
            "identifier": "16065",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan J. Shamus, P.A.
• Sara Shanahan, CNM
• Tamelyn Shane
• Cynthia Ann Shannon
• Dianna Marie Shannon, FNP-C
• Janet Muth Shannon, PT
• Kaiya Shannon, LCSW
• Dana Leeann Shapcott, PA-C
• Amanda G Shapiro
• Harvey Harris Shapiro, MD

• Orthopaedic Surgery Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Orthopaedic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2018; 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.