Individual provider Active NPI

Shannon M Joyce, MD

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1790769289
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01045328A Issued in IN
Practice address
5926 Crawfordsville Rd Unit B
Indianapolis, IN 46224-3722
Phone
(317) 653-2730
Fax
(317) 623-1440
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 01045328A IN
Family Medicine Physician 207Q00000X 01045328A IN Primary

Addresses

Primary practice location

5926 Crawfordsville Rd Unit B
Indianapolis, IN 46224-3722

Mailing address

5926 Crawfordsville Rd Unit B
Indianapolis, IN 46224-3722
Phone (317) 653-2730

Other identifiers 1

IdentifierTypeStateIssuer
200185170MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20101101000919 IN Practitioner - Family PracticePractitioner - Geriatric Medicine 5193919421

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01045328AINMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Physician Services Hospital and Health Care Center Family Medicine Current Accepting new patients
Oak Street Health Physicians Group, PC PastSince Mar 21, 2016 Accepting new patients

Locations

8240 Naab Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 338-7450

8240 Naab Rd
Ste 155
Indianapolis, IN 46260
Phone (317) 338-7760

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1790769289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5926 CRAWFORDSVILLE RD UNIT B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462243722",
            "telephone_number": "317-653-2730",
            "fax_number": "317-623-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5926 CRAWFORDSVILLE RD UNIT B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462243722",
            "telephone_number": "317-653-2730",
            "fax_number": "317-623-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOYCE",
        "first_name": "SHANNON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IN",
            "license": "01045328A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01045328A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200185170",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.