NPIMap

Individual provider Active NPI

Michelle Lee Shannon

  • Certified Registered Nurse Anesthetist
  • Greenville, SC
National Provider Identifier
1780270728
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
24566 Issued in SC
Practice address
7 Independence PT Ste 300
Greenville, SC 29615-4569
Phone
(864) 522-3700
NPI assigned
Dec 14, 2020
Reactivated
Feb 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 24566 SC Primary

Addresses

Primary practice location

7 Independence PT Ste 300
Greenville, SC 29615-4569

Mailing address

300 E McBee Ave FL 4Yh
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

248 Cross Keys Rd
Berlin, NJ 08009-2053
Phone (856) 889-5162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210219000561 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002221322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, shared by 5 NPIs, 2,467 clinicians
Trident Anesthesia Group LLCGroup PAC ID 5294631545, 121 clinicians

Practice addresses (Care Compare)

7 Independence PT
Suite 300
Greenville, SC 29615-4569
Phone (864) 522-3700

9263 Medical Plaza Dr
Suite E
Charleston, SC 29406-7112
Phone (843) 572-1228

Hospital & facility affiliations

  • Trident Medical Center Hospital, Charleston, SC, CCN 420079
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Trident Anesthesia Group, LLC CurrentSince Mar 1, 2021 Accepting new patients

Locations

423 Barony St
Moncks Corner, SC 29461

9263 Medical Plaza Dr
Ste E
North Charleston, SC 29406
Phone (843) 572-1228

9313 Medical Plaza Dr
Ste 102
North Charleston, SC 29406
Phone (843) 572-1228

295 Midland Pkwy
Summerville, SC 29485
Phone (843) 554-6366

Organizations & group practices 1

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.

Hospital & facility affiliations 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1780270728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4YH",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 INDEPENDENCE PT STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154569",
            "telephone_number": "864-522-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "248 Cross Keys Rd",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "NJ",
            "postal_code": "080092053",
            "country_code": "US",
            "telephone_number": "856-889-5162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "MICHELLE",
        "middle_name": "LEE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "deactivation_date": "2020-12-15",
        "reactivation_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "24566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.