Active NPI
Shannon Elizabeth Garbus
- Medical Physician Assistant
- Cleveland, OH
National Provider Identifier
1699287433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 33.021334
- Practice address
- 6829 Broadway Ave
Cleveland, OH 44105-1313 - Phone
- (216) 271-1133
- NPI assigned
- Nov 2, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 33.021334 | OH | Primary |
Addresses
Primary practice location
6829 Broadway Ave
Cleveland, OH 44105-1313
Mailing address
6829 Broadway Ave
Cleveland, OH 44105-1313
Phone (216) 271-1133
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 |
|---|---|---|---|
| 33.021334 | OH | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509580800000",
"number": "1699287433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6829 BROADWAY AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441051313",
"telephone_number": "216-271-1133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6829 BROADWAY AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441051313",
"telephone_number": "216-271-1133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARBUS",
"first_name": "SHANNON",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-02",
"last_updated": "2017-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "OH",
"license": "33.021334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.