Individual provider Active NPI

Shannon Ryan-Cebula, MD

  • Family Medicine Physician
  • Lakewood, CO
National Provider Identifier
1619131018
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
47532 Issued in CO
Practice address
8383 W Alameda Ave
Lakewood, CO 80226-3007
Phone
(303) 338-4545
NPI assigned
Jul 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TL2435 CO
Family Medicine Physician 207Q00000X 47532 CO Primary

Addresses

Primary practice location

8383 W Alameda Ave
Lakewood, CO 80226-3007

Mailing address

10900 W 44TH Ave Unit 200
Wheat Ridge, CO 80033-2742
Phone (720) 923-1250

Other identifiers 2

IdentifierTypeStateIssuer
020783OtherCOKAISER COMMERCIAL NUMBER
26905566MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20110208001066 CO Practitioner - Family PracticePractitioner - Hospice/Palliative Care 9638359649 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47532COMDFamily Medicine Physician
TL2435COMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Housecalls LLC CurrentSince Mar 10, 2024 Accepting new patients

Locations

12600 W Colfax Ave
Ste B200
Lakewood, CO 80215
Phone (303) 459-4000

10900 W 44th Ave
Wheat Ridge, CO 80033
Phone (303) 379-9371

10900 W 44th Ave
Unit 200
Wheat Ridge, CO 80033
Phone (303) 379-9371

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CICGBD

Organizations & group practices 1

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": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1619131018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 W 44TH AVE UNIT 200",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332742",
            "telephone_number": "720-923-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8383 W ALAMEDA AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802263007",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN-CEBULA",
        "first_name": "SHANNON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-15",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL2435",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "47532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "020783",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26905566",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.