Shannon Renae Sutherland, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

34.008522 Issued in OH

Practice address

1103 Village Square Dr
Suite 101
Perrysburg, OH 43551-1783

Phone

(419) 872-3219

Fax

(419) 872-3208

NPI assigned

Dec 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Shannon Renae Lucente Former name

Medicare fee-for-service enrollment

Enrolled in OH, ID2 enrollments

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 2

Specialty

Obstetrics/Gynecology

Education

West Virginia School of Osteopathic Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.sutherlanddofacog.p1@direct.whc.nextgenshare.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/m6q718FZg_-IH-imjhHk1P9jJGSwQzGK/
• Direct secure messaging: shannon.sutherlanddofacog.p2@direct.whc.nextgenshare.com

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.

• BMH, Inc.

  • Surgery Physician
  • Blackfoot, ID
  • NPI 1255539193
  Medicare reassignment NPD
• BMH Inc.

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1881190650
  NPD
• BMH, Inc.

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1295502995
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Wood County Hospital Assn

  • General Acute Care Hospital
  • Bowling Green, OH
  • NPI 1790751253
  NPD (past)
• BMH Inc.

  • Rural Health Clinic/Center
  • Blackfoot, ID
  • NPI 1770785875
  NPD (past)
• Mountain River Birthing and Surgery Center LLC

  • General Acute Care Hospital
  • Blackfoot, ID
  • NPI 1851371959
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bay Park Community Hospital

  • General Acute Care Hospital
  • Oregon, OH
  • NPI 1598765539
  Care Compare affiliation

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295308800000",
    "number": "1740266501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 MONCLOVA RD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "43537",
            "telephone_number": "419-872-3201",
            "fax_number": "419-872-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 VILLAGE SQUARE DR",
            "address_2": "SUITE 101",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511783",
            "telephone_number": "419-872-3219",
            "fax_number": "419-872-3208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "SHANNON",
        "middle_name": "RENAE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2011-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "BL9255058",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "34.008522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2604793",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "LUCENTE",
            "middle_name": "RENAE",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Stusek
• Clarissa Suguitan
• Christina Lyn Summers, FNP-C
• Kylar A Sunderland
• Sunrise Center Healthcare, LLC.
• Joel R Sutton, PH.D., P.C.C.
• Benjamin Jeffery Swartz, MD
• Kristin Marie Swartz, ATC
• Aldena K Sweeney, LCDCIII
• Syl-Haven Medical Clinic, Inc.

• Obstetrics & Gynecology Physician in Perrysburg, OH
• Providers in Perrysburg, OH by specialty
• Obstetrics & Gynecology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; 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.