Active NPI
Faye J. Shannon
- Clinical Social Worker
- Hastings, MI
National Provider Identifier
1801900543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801020120
- Practice address
- 450 Meadow Run Dr
Hastings, MI 49058-9053 - Phone
- (269) 948-8465
- NPI assigned
- Aug 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801020120 | MI | Primary |
Addresses
Primary practice location
450 Meadow Run Dr
Hastings, MI 49058-9053
Mailing address
450 Meadow Run Dr
Hastings, MI 49058-9053
Phone (269) 948-8465
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6130497 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801020120 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801900543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 MEADOW RUN DR",
"city": "HASTINGS",
"state": "MI",
"postal_code": "490589053",
"telephone_number": "269-948-8465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 MEADOW RUN DR",
"city": "HASTINGS",
"state": "MI",
"postal_code": "490589053",
"telephone_number": "269-948-8465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANNON",
"first_name": "FAYE",
"middle_name": "J.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801020120",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6130497",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hastings, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.