Shanta Corporation

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

MI834710 Issued in MI

Legal business name

SHANTA CORPORATION

Doing business as

St Annes Convalescent Center

Practice address

6232 Cadieux Rd
Detroit, MI 48224-3812

Phone

(313) 886-2500

NPI assigned

Oct 6, 2005

Organization subpart

No

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

Authorized official

Name

Thomas Beauvais

Title

Administrator

Phone

(313) 886-2500

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• ST ANNES CONVALESCENT CENTER Doing business as

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325030400000",
    "number": "1801883632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6232 CADIEUX RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482243812",
            "telephone_number": "313-886-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6232 CADIEUX RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482243812",
            "telephone_number": "313-886-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANTA CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2011-12-28",
        "status": "A",
        "authorized_official_last_name": "BEAUVAIS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "313-886-2500"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "MI834710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "235415",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548356",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "MI834710",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST ANNES CONVALESCENT CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marquisa Danae Shannon, B.A,M.B.A
• Melissa Shannon, R.D.
• Phillip Shannon
• Shanna Shannon
• Shanny's Home Care LLC
• Christina Mubarak Shanti, M.D.
• Yusra Fatima Shao, MD
• Peter Shaouni
• Ashley Shaow
• Helene Shapero, M.D. PHD

• Skilled Nursing Facility in Detroit, MI
• Providers in Detroit, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.