Lisa Shannon DO, PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LISA SHANNON DO, PA

Practice address

250 2ND St E Ste 3B
Bradenton, FL 34208-1027

Phone

(941) 746-4151

NPI assigned

Jan 6, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Lisa Shannon, DONPI 1548514615

Title

Physician

Phone

(941) 746-4151

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Shannon, D.O.

  • Family Medicine Physician
  • Bradenton, FL
  • NPI 1548514615
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1639718836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 2ND ST E STE 3B",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081027",
            "telephone_number": "941-746-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 2ND ST E STE 3B",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081027",
            "telephone_number": "941-746-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA SHANNON DO, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-06",
        "last_updated": "2023-09-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "941-746-4151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011944000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Linda Lipman
• Steven Lipman, MD
• Kevin P Lipscomb, M.D.
• Bruce R Lipskind, M.D.
• Lisa M. Davis, LLC
• Andrew Z. Liskiewicz, M.D.
• Listennow Hearing & Speech, LLC
• Carlo Mario Litano, D.M.D.
• Mario E Litano, M.D.
• Sharon C Litschauer, ARNP

• Primary Care Clinic/Center in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.