Kevin Micheal Shannon, M.D.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

G64023 Issued in CA

Practice address

10833 Le Conte Ave
Los Angeles, CA 90095-3075

Phone

(310) 825-5296

Fax

(310) 825-9524

NPI assigned

Jun 27, 2006

Sex

Male

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 CA

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

Pediatric Medicine

Education

Columbia University College of Physicians and Surgeons, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

UC RegentsGroup PAC ID 4587568829, 97 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

77.64 of 100Reported as group

Quality

82.13

Promoting interoperability

100

Improvement activities

40

Cost

10

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kshannon48788@direct.uclahealth.org

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.

• UC Regents

  • Pediatrics Physician
  • Los Angeles, CA
  • NPI 1982667663

  Pediatric Cardiology

  Medicare reassignment Care Compare group NPD
• The Regents of the University of California

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1235107566
  Medicare reassignment NPD
• The Regents of the University of California

  • Ambulatory Surgical Clinic/Center
  • Valencia, CA
  • NPI 1689200305
  NPD
• Regents Univ of Calif Los Angeles

  • Psychiatric Hospital
  • Los Angeles, CA
  • NPI 1952308363
  NPD (past)
• UCLA Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1043427248
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1629005368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-825-5296",
            "fax_number": "310-825-9524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-825-5296",
            "fax_number": "310-825-9524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "KEVIN",
        "middle_name": "MICHEAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "G64023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G640230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Fontaine Shannon-Amely, NP
• Angela P. Shannon, M.D.
• Chelsea Lee Shannon, MD
• Dewanna Denise Shannon, MS
• James Benjamin Shannon, THERAPIST
• Makaila Shannon
• Mary Vivianne Shannon, DDS
• Tara Rose Shannon
• Taylor Leslie Shannon, MD
• Venita Shannonhouse

• Pediatric Cardiology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pediatric Cardiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.