Shanon Lee Mekola

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71008506A Issued in IN

Practice address

10176 W 400 N Ste C
Michigan City, IN 46360-9009

Phone

(219) 873-1777

Fax

(219) 873-0001

NPI assigned

Aug 22, 2018

Last updated

Nov 2, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in IN, OH, NC3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Smart Physician Systems PCGroup PAC ID 3678853645, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Smart Physician Systems PC

  • Internal Medicine Physician
  • Michigan City, IN
  • NPI 1023550183
  Medicare reassignment Care Compare group NPD
• North Indiana Emergency Physicians, LLP

  • Emergency Medicine Physician
  • La Porte, IN
  • NPI 1144691478
  Medicare reassignment NPD
• Boulder Care Provider Group PA

  dba Boulder Care

  • Addiction Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1649838590

  NC, OH

  Medicare reassignment NPD
• Alternative Healing Works LLC

  • Acupuncturist
  • Dyer, IN
  • NPI 1710203039
  NPD
• Continuim Wellness, LLC.

  • Medical Specialty Clinic/Center
  • Dyer, IN
  • NPI 1578170486
  NPD

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1568943231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10176 W 400 N STE C",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463609009",
            "telephone_number": "219-873-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10176 W 400 N STE C",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463609009",
            "telephone_number": "219-873-1777",
            "fax_number": "219-873-0001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1007 Lincolnway",
            "address_purpose": "LOCATION",
            "city": "LA Porte",
            "state": "IN",
            "postal_code": "46350",
            "country_code": "US",
            "telephone_number": "219-326-1234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6195 Marcella Blvd",
            "address_purpose": "LOCATION",
            "city": "Hobart",
            "state": "IN",
            "postal_code": "463420040",
            "country_code": "US",
            "telephone_number": "219-942-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEKOLA",
        "first_name": "SHANON",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008506A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordon Medlock, PHD, LCSW
• Monica Medrano, MD, MS
• Medspa Womans Healthcare PC
• Meijer Stores Limited Partnership (Meijer Pharmacy #149)
• Milton A Meinhardt, MD
• Yesenia Mendoza, APRN
• Nikole Ember Meredith, OTR
• Michael J Messina, DO
• Marietta Meuli, ATC
• Michael J Hayduk DDS MSD PC

• Family Nurse Practitioner in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.