Shannon E. McCormack, D.O.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

64097-21 Issued in WI

Practice address

1969 W Hart Rd
Beloit Memorial Hospital
Beloit, WI 53511-2230

Phone

(608) 363-5971

Fax

(608) 363-5737

NPI assigned

May 18, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Internal MedicineAlso: Hospitalist

Education

Midwestern University, Chicago College of Osteopathic Med, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beaver Dam Community Hospitals Inc.Group PAC ID 2567370539, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshfield Medical Center - Beaver Dam (MMC-BD) Hospital, Beaver Dam, WI, CCN 520076
• SSM Health St Mary'S Hospital - Madison Hospital, Madison, WI, CCN 520083

Merit-based Incentive Payment System (MIPS)

Final score

78.6 of 100Reported as group

Quality

56.02

Promoting interoperability

100

Improvement activities

40

Cost

72.66

Merit-based Incentive Payment System (MIPS)

Final score

85.73 of 100Reported as group

Quality

87.42

Promoting interoperability

100

Improvement activities

40

Cost

65.02

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smccormack505124@direct-ehr-ssmhc.com
• Direct secure messaging: shannon.mccormack@marshfieldclinichealthsystem.cernerdirect.com

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.

• Beaver Dam Community Hospitals Inc

  • Clinic/Center
  • Beaver Dam, WI
  • NPI 1972188555
  Medicare reassignment Care Compare group NPD
• Stoughton Hospital Association

  • Critical Access Hospital
  • Stoughton, WI
  • NPI 1679558647
  Medicare reassignment NPD
• Beaver Dam Community Hospitals Inc

  • Pharmacy
  • Beaver Dam, WI
  • NPI 1295771780
  NPD
• MCHS Hospitals Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434

  Internal Medicine

  NPD
• Stoughton Hospital Association

  • Psychiatric Hospital Unit
  • Stoughton, WI
  • NPI 1437296456
  NPD
• Stoughton Hospital Association

  • Urgent Care Clinic/Center
  • Cottage Grove, WI
  • NPI 1811733066
  NPD

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

• Beaver Dam Community Hospitals Inc

  • General Acute Care Hospital
  • Beaver Dam, WI
  • NPI 1023187416
  Care Compare affiliation
• Beaver Dam Community Hospitals Inc

  • Clinic/Center
  • Beaver Dam, WI
  • NPI 1508184896

  Hospital

  Care Compare affiliation
• SSM Health Care of Wisconsin, Inc.

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1184621211
  Care Compare affiliation

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1588924054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 E HUEBBE PKWY",
            "address_2": "BELOIT HEALTH SYSTEM INC",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-2200",
            "fax_number": "608-363-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1969 W HART RD",
            "address_2": "BELOIT MEMORIAL HOSPITAL",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535112230",
            "telephone_number": "608-363-5971",
            "fax_number": "608-363-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "SHANNON",
        "middle_name": "E.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-18",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101019893",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5101019893",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "64097-21",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "64097-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100045471",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa McAllister
• Karleen F. McBride, PA
• Sandra A McClintic, RN
• Taylor McClinton
• Haven Macgregor McClure, APSW
• Morgan Nicole McEntire, PA
• Lee Alan McFadden, M.D.
• Jayme McHone, LPN
• Nicole Lynn McKeown, MS, LPC
• Evan McNamara, PHARMD

• Hospitalist Physician in Beloit, WI
• Providers in Beloit, WI by specialty
• Hospitalist Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.