Shannon Gabrielle Snider, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005686 Issued in MI

Practice address

3434 M 119 Ste C
Harbor Springs, MI 49740-9373

Phone

(231) 348-9900

NPI assigned

Jun 29, 2010

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 identifiers 1

Other names 1

• Shannon Gabrielle Duty Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ms_ssnider7@landmarkhealth-direct.org

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.

• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  Physician Assistant

  Medicare reassignment NPD
• Complexcare Medical Group Midwest H PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1457144933
  Medicare reassignment
• Alcona Citizens for Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Pellston, MI
  • NPI 1174064869
  NPD (past)
• Emergency Care Specialists PC

  • Emergency Medicine Physician
  • Grand Rapids, MI
  • NPI 1093766958
  NPD (past)

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1689985228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 M 119 STE C",
            "city": "HARBOR SPRINGS",
            "state": "MI",
            "postal_code": "497409373",
            "telephone_number": "231-348-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 M 119 STE C",
            "city": "HARBOR SPRINGS",
            "state": "MI",
            "postal_code": "497409373",
            "telephone_number": "231-348-9900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "421 Stimpson Dr Unit 102",
            "address_purpose": "LOCATION",
            "city": "Pellston",
            "state": "MI",
            "postal_code": "497698800",
            "country_code": "US",
            "telephone_number": "231-844-3051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNIDER",
        "first_name": "SHANNON",
        "middle_name": "GABRIELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "5601005686",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shannon.snider.p1@direct.alcona.nextgenshare.com",
            "affiliation": "N",
            "address_1": "3434 M 119 Ste C",
            "city": "Harbor Springs",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497409373",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shannon.snider.p1@direct.alcona.nextgenshare.com",
            "affiliation": "N",
            "address_1": "421 Stimpson Dr Unit 102",
            "city": "Pellston",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497698800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "DUTY",
            "middle_name": "GABRIELLE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Thomas Scholtz, OTR
• Vincent E. Schultz, MD
• John Edward Shaloy
• Marty P Sheridan-Parks, PTA
• Lauren Smith, LMSW
• Joseph Sobota, M. D.
• William Joel Steinbach, D.C.
• Jean M Stolt, RDH
• Rene Rochelle Straub, NP-C
• Kerby M Tamm, DPT

• Physician Assistant in Harbor Springs, MI
• Providers in Harbor Springs, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.