Active NPI
Spencer Lee Shannon, DC
- Chiropractor
- Wadesville, IN
National Provider Identifier
1669120101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 08003282A
- Practice address
- 7125 Highway 66
Wadesville, IN 47638-9635 - Phone
- (812) 637-4947
- NPI assigned
- Mar 14, 2022
- Last updated
- Mar 14, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 08003282A | IN | Primary |
Addresses
Primary practice location
7125 Highway 66
Wadesville, IN 47638-9635
Mailing address
320 Wabash Cir
Chandler, IN 47610-9387
Phone (870) 349-4344
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08003282A | IN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647216000000",
"number": "1669120101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 WABASH CIR",
"city": "CHANDLER",
"state": "IN",
"postal_code": "476109387",
"telephone_number": "870-349-4344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7125 HIGHWAY 66",
"city": "WADESVILLE",
"state": "IN",
"postal_code": "476389635",
"telephone_number": "812-637-4947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANNON",
"first_name": "SPENCER",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-14",
"last_updated": "2022-03-14",
"certification_date": "2022-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IN",
"license": "08003282A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wadesville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.