Shannon Gammill Berry, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

208173 Issued in LA

Practice address

1635 Marvel St
Coushatta, LA 71019-9022

Phone

(318) 932-2000

NPI assigned

Jun 5, 2009

Last updated

Oct 25, 2016By the provider in NPPES

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 2

Other names 1

• Shannon Gammill Smith Former name

Medicare fee-for-service enrollment

Enrolled in LA, FL2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: shbe3681@yourcarecommunity.org

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.

• Coushatta ER Physicians

  • Emergency Medicine Physician
  • Coushatta, LA
  • NPI 1427480680
  Medicare reassignment NPD
• East Carroll Parish Hospital

  • General Acute Care Hospital
  • Lake Providence, LA
  • NPI 1982695441
  Medicare reassignment NPD
• Ed Physicians of West Louisiana, LLC

  • Emergency Medicine Physician
  • West Monroe, LA
  • NPI 1255460143
  Medicare reassignment NPD
• Emergency Staffing Solutions Inc

  • Emergency Medicine Physician
  • Many, LA
  • NPI 1477590974
  Medicare reassignment NPD
• Northern Louisiana Emergency Physicians, LLP

  dba Northern Louisiana Physicians LLP

  • Emergency Medicine Physician
  • Ruston, LA
  • NPI 1588828172
  Medicare reassignment NPD
• Oakdale Ess LLC

  • Emergency Medicine Physician
  • Oakdale, LA
  • NPI 1750785119
  Medicare reassignment NPD
• Richland Parish Hospital Service District No 1-B

  dba Richardson Medical Center

  • General Acute Care Hospital
  • Rayville, LA
  • NPI 1255370144
  Medicare reassignment NPD
• Concord North Texas, PLLC

  • Emergency Medicine Physician
  • Bonham, TX
  • NPI 1952761173

  LA

  Medicare reassignment NPD
• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment NPD
• Ess Hospitalist LLC

  • Hospitalist Physician
  • Crossett, AR
  • NPI 1881967305

  LA

  Medicare reassignment NPD
• Floridian Emergency Specialists LLC

  • Emergency Medicine Physician
  • Melbourne, FL
  • NPI 1710210695
  Medicare reassignment NPD
• East Carroll Parish Hospital

  dba Family Medical Clinic-Behavioral Health

  • Federally Qualified Health Center (FQHC)
  • Lake Providence, LA
  • NPI 1508603168
  NPD

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1770719668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 MARVEL ST",
            "city": "COUSHATTA",
            "state": "LA",
            "postal_code": "710199022",
            "telephone_number": "318-932-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 MARVEL ST",
            "city": "COUSHATTA",
            "state": "LA",
            "postal_code": "710199022",
            "telephone_number": "318-932-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "SHANNON",
        "middle_name": "GAMMILL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-05",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "208173",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P1727",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P01575286",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2400894",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "SMITH",
            "middle_name": "GAMMILL",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lavora Babers-Wilson, APRN-NP
• Christopher Troy Bamburg, PA-C
• Bridgette Neal Bates, OT
• Kelley Kaitlyn Squires Beard, LOTR
• Don Gregory Bell, MD
• Bio-Medical Applications of Louisiana, LLC (FMC Dialysis Services Coushatta)
• Ruby Braxton
• Lesley Carr, FNP-C
• Martin John Carter, MD
• Joshua Ray Cason, MD

• Emergency Medicine Physician in Coushatta, LA
• Providers in Coushatta, LA by specialty
• Emergency Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.