Shannon L Gullett, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

60295541205 Issued in UT

Practice address

5770 S 250 E Ste 300
Murray, UT 84107-8100

Phone

(801) 314-2500

Fax

(801) 314-2501

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Shannon G Blackburn Former name

Medicare fee-for-service enrollment

Enrolled in UT

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

Psychiatry

Education

Medical University of South Carolina College of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Family Medicine Physician
  • Richfield, UT
  • NPI 1265576326
  NPD
• Ihc Health Services Inc

  • Diagnostic Radiology Physician
  • Murray, UT
  • NPI 1285019737
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Midvale, UT
  • NPI 1891810867
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1669559118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5770 S 250 E STE 300",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841078100",
            "telephone_number": "801-314-2500",
            "fax_number": "801-314-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 S 250 E STE 300",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841078100",
            "telephone_number": "801-314-2500",
            "fax_number": "801-314-2501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 E Fort Union Blvd",
            "address_2": "suite 215",
            "address_purpose": "LOCATION",
            "city": "Cottonwood Heights",
            "state": "UT",
            "postal_code": "840471889",
            "country_code": "US",
            "telephone_number": "801-233-4200",
            "fax_number": "801-233-4639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GULLETT",
        "first_name": "SHANNON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "60295541205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "BLACKBURN",
            "middle_name": "G",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Wayne Guidry, MD
• Laura Emelda Guillen
• Sandra Guillen, APRN
• Laura Guilmain, BSN, RN
• Justin D Gull, M.D.
• Nancy Elizabeth Gundersen, M.D.
• Alexis Gunderson
• Sonia Gupta, MBBS
• Rachel Dresher Gurr, PA-C
• Marlana Gayle Gurule

• Psychiatry Physician in Murray, UT
• Providers in Murray, UT by specialty
• Psychiatry Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; 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.