Travis M. Shannon

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401410489 Issued in VA

Practice address

3533 Keagy Rd
Salem, VA 24153-7312

Phone

(540) 989-5700

NPI assigned

Mar 23, 2007

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

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Mills & Shannon, DMD, PC

  • General Practice Dentistry
  • Salem, VA
  • NPI 1073843777
  NPD (past) Authorized official
• Richard D Smith II DDS PC

  • General Practice Dentistry
  • Roanoke, VA
  • NPI 1285955260
  NPD (past)

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1669599924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 MILLWHEEL LN",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241534734",
            "telephone_number": "540-387-2855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 KEAGY RD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537312",
            "telephone_number": "540-989-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "TRAVIS",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hani Abdel Meguid Shabana, PH.D.
• Harry Gustavus Shaffer IV, MD
• Siddharth Shah
• Kelly Shaner, PT
• John R Shannon, M. D.
• Faranak M. Sharifi
• Marie Sharkey, M.D.
• Shivam Sharma, MD
• Ashley Shaver, COTA/L
• Kayla Shaw, LCSW

• General Practice Dentistry in Salem, VA
• Providers in Salem, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.