Individual provider Active NPI

Shannon J Schwab, DO

  • Family Medicine Physician
  • North Mankato, MN
National Provider Identifier
1548245012
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40982 Issued in MN
Practice address
1575 Lookout Dr
North Mankato, MN 56003-2503
Phone
(507) 625-8111
Fax
(507) 625-6282
NPI assigned
Dec 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Q5925 TX
Family Medicine Physician 207Q00000X 40982 MN Primary

Addresses

Primary practice location

1575 Lookout Dr
North Mankato, MN 56003-2503

Mailing address

PO Box 8674
Mankato, MN 56002-8674
Phone (507) 625-1811

Other practice location 1

8288 S Broadway Ave
Tyler, TX 75703
Phone (903) 606-7060

Other names 1

  • Shannon J Kowal Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, MI2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20100607000448 MN Practitioner - Family Practice 4284764994
I20211019001354 MI Practitioner - Family Practice 4284764994 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40982MNMDFamily Medicine Physician
Q5925TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc. Current Accepting new patients
Covenant Medical Center, Inc Family Medicine CurrentSince Dec 8, 2021 Accepting new patients
Covenant Medical Center, Inc. CurrentSince Dec 8, 2021 Accepting new patients
Iha Health Services Corporation Family Medicine CurrentSince Nov 1, 2021 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Ross Summers MD PLLC Family Medicine CurrentSince Nov 6, 2023 Accepting new patients
Iha Health Service Corporation CurrentSince Nov 1, 2021 Accepting new patients
Mayo Clinic Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

16440 Gratiot Rd
Hemlock, MI 48626
Phone (989) 583-0660

308 S Main St
Northville, MI 48167
Phone (248) 349-0627

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

5570 State St
Saginaw, MI 48603
Phone (989) 583-0100

Interoperability endpoints

  • Direct secure messaging: sschwab109949@christushealth.direct-ci.net
  • Direct secure messaging: sschwab114915@direct.covenanthealthcare.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1548245012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8674",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560028674",
            "telephone_number": "507-625-1811",
            "fax_number": "507-625-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 LOOKOUT DR",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560032503",
            "telephone_number": "507-625-8111",
            "fax_number": "507-625-6282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8288 S Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "75703",
            "country_code": "US",
            "telephone_number": "903-606-7060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHWAB",
        "first_name": "SHANNON",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q5925",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "40982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "KOWAL",
            "middle_name": "J",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Mankato, MN

Sources for this page

Verify at the official NPI Registry.