Thomas Oswald Shannon, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

J5014 Issued in TX

Practice address

3115 College Park Drive
Ste 101
The Woodlands, TX 77384-4001

Phone

(936) 321-4345

Fax

(936) 321-4353

NPI assigned

Aug 24, 2006

Last updated

Sep 16, 2015By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Plastic and Reconstructive Surgery

Education

Pennsylvania State University College of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mid-South Medical Management LLCGroup PAC ID 5698217404, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tshannon@kprs.directglo.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mid-South Medical Management LLC

  • Internal Medicine Physician
  • Plano, TX
  • NPI 1689439481
  Medicare reassignment Care Compare group NPD
• Healing Hands Advanced Wound Care LLC

  • Plastic and Reconstructive Surgery Physician
  • Irving, TX
  • NPI 1487443644
  Medicare reassignment NPD
• Keystone Outpatient Services, LLC

  • Ambulatory Surgical Clinic/Center
  • The Woodlands, TX
  • NPI 1386830800
  Authorized official Same address or phone
• Keystone Plastic Reconstructive Surgery,LLC

  • Plastic and Reconstructive Surgery Physician
  • The Woodlands, TX
  • NPI 1598977290
  Authorized official Same address or phone
• Keystone Surgicenter LLC

  • Ambulatory Surgical Clinic/Center
  • The Woodlands, TX
  • NPI 1386199354
  Authorized official Same address or phone

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1689781841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 COLLEGE PARK DRIVE",
            "address_2": "STE 101",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844001",
            "telephone_number": "936-321-4345",
            "fax_number": "936-321-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 COLLEGE PARK DRIVE",
            "address_2": "STE 101",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844001",
            "telephone_number": "936-321-4345",
            "fax_number": "936-321-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "THOMAS",
        "middle_name": "OSWALD",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "J5014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080725701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139377915",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Atif Shahzad, MD
• Jahanzeb Rafi Shaikh, MD
• Shail Maheshwari MD PLLC
• Shaker Emergency Specialists, PLLC
• Akeil Shams-Ul-Hooda
• Shantell's Pro Screenings
• Jeff Yuan Shao, D.D.S., M.S.
• Bharat Sharma, M.D.
• Shivaramaiah Shashikumar, MD
• Meena Wilson Shatby, MD

• Plastic and Reconstructive Surgery Physician in The Woodlands, TX
• Providers in The Woodlands, TX by specialty
• Plastic and Reconstructive Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; 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.