Shannon Michelle Clark, MD

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

L8653 Issued in TX

Practice address

301 University Blvd
Galveston, TX 77555-5302

Phone

(409) 772-2222

NPI assigned

Dec 13, 2006

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Specialty

Obstetrics/Gynecology

Education

University of Louisville School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Texas Medical Branch Galveston Hospital, Galveston, TX, CCN 450018

Merit-based Incentive Payment System (MIPS)

Final score

78.88 of 100Reported as group

Quality

73.38

Improvement activities

40

Cost

78.42

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sclarkmd15160@direct.utmb.edu

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.

• Utmb Faculty Group Practice

  • General Practice Physician
  • Galveston, TX
  • NPI 1942241146

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• University of Texas Medical Branch at Galveston

  • General Acute Care Hospital
  • Galveston, TX
  • NPI 1548226988
  NPD (past)
• University of Texas Medical Branch at Galveston

  • Community/Retail Pharmacy
  • Friendswood, TX
  • NPI 1699532861
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University of Texas Medical Branch at Galveston

  • General Acute Care Hospital
  • Galveston, TX
  • NPI 1548226988
  Care Compare affiliation

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1568524106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555302",
            "telephone_number": "409-772-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555302",
            "telephone_number": "409-772-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SHANNON",
        "middle_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "TX",
            "license": "L8653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165852801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nitza M Cintron, MD
• Ashley Renee Cis, APRN, FNP-C
• Carlos Adrian Clark, DO
• Jean L Clark, PA-C
• Justin Steven Clark, D.O.
• Susan Annette Clawson, ENP
• Cecilia Gladys Clement, MD
• Patti L Clements, NNP
• Corey Charles Clifford, D.O./MBA
• Eric Cline

• Maternal & Fetal Medicine Physician in Galveston, TX
• Providers in Galveston, TX by specialty
• Maternal & Fetal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.