Individual provider Active NPI

Shannon Devries, MD

  • Hospitalist Physician
  • Omaha, NE
National Provider Identifier
1801413117
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
35589 Issued in NE
Practice address
7500 Mercy Rd
Omaha, NE 68124-2319
Phone
(855) 524-4001
Fax
(402) 398-5589
NPI assigned
Jul 2, 2020
Last updated
Jun 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35589 NE
Hospitalist Physician 208M00000X 35589 NE Primary

Addresses

Primary practice location

7500 Mercy Rd
Omaha, NE 68124-2319

Mailing address

7710 Mercy Rd Ste 202
Omaha, NE 68124-2353

Other practice location 1

7710 Mercy Rd Ste 202
Omaha, NE 68124-2353
Phone (402) 280-4392

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230628000939 NE Practitioner - Hospitalist 6305261728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Creighton University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

7500 Mercy Rd
Omaha, NE 68124-2319
Phone (402) 398-5580

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35589NEMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Jul 18, 2023 Accepting new patients
Alegent Health Bergan Mercy Health System Past Accepting new patients
Alegent Creighton Clinic Internal Medicine Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

7500 Mercy Rd
Omaha, NE 68124
Phone (402) 398-5880

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1801413117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7710 MERCY RD STE 202",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242319",
            "telephone_number": "855-524-4001",
            "fax_number": "402-398-5589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7710 Mercy Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681242353",
            "country_code": "US",
            "telephone_number": "402-280-4392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVRIES",
        "first_name": "SHANNON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "35589",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NE",
            "license": "35589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.