NPIMap

Individual provider Active NPI

Shannon Haenel, D.O.

  • Hematology & Oncology Physician
  • Wilmington, NC
National Provider Identifier
1811124365
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
2023-03041 Issued in NC
Practice address
2421 Silver Stream LN
Wilmington, NC 28401-7684
Phone
(910) 341-3453
NPI assigned
Jun 11, 2009
Last updated
Jan 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10034619 TX
Hematology & Oncology Physician 207RH0003X 05-38452 KS
Hematology & Oncology Physician 207RH0003X 6314 OK
Hematology & Oncology Physician 207RH0003X 2023-03041 NC Primary

Addresses

Primary practice location

2421 Silver Stream LN
Wilmington, NC 28401-7684

Mailing address

1202 Medical Center Dr
Wilmington, NC 28401-7307
Phone (910) 341-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231201001860 NC Practitioner - Hematology/Oncology 9032373451 Reassigns benefits to 1 organization
I20251124002788 SC Practitioner - Hematology/Oncology 9032373451 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Ohio University, College of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians
Georgetown Memorial HospitalGroup PAC ID 8224942123, 90 clinicians

Practice addresses (Care Compare)

2421 Silver Stream LN
Wilmington, NC 28401-7684
Phone (910) 341-1540

4181 Hwy 17
Murrells Inlet, SC 29576-5019
Phone (843) 520-8881

606 Black River Rd
Georgetown, SC 29440-3304
Phone (843) 527-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
53.73
Promoting interoperability
100
Improvement activities
40
Cost
70.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10034619TXMDInternal Medicine Physician
05-38452KSMDHematology & Oncology Physician
6314OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wha Medical Clinic PLLC Current Accepting new patients
Wilmington ASC LLC CurrentSince Jan 16, 2024 Accepting new patients
Georgetown Physician Associates, LLC CurrentSince Jan 12, 2026 Accepting new patients
Georgetown Memorial Hospital CurrentSince Jan 12, 2026 Accepting new patients
Georgetown Physician Associates LLC Internal Medicine CurrentSince Jan 12, 2026 Accepting new patients
Wilmington Health PLLC CurrentSince Jan 16, 2024 Accepting new patients
Georgetown Memorial Hospital CurrentSince Jan 12, 2026 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Georgetown Physician Services, LLC Past Accepting new patients

Locations

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

2421 Silver Stream Ln
Wilmington, NC 28401
Phone (910) 763-2072

606 Black River Rd
Georgetown, SC 29440
Phone (843) 527-7000

2347 S Highway 17
Murrells Inlet, SC 29576
Phone (843) 357-2443

4181 Highway 17
Murrells Inlt, SC 29576
Phone (843) 651-3308

1220 21st Ave N
Myrtle Beach, SC 29577
Phone (843) 652-8300

12117 Ocean Hwy
Pawleys Island, SC 29585
Phone (843) 237-8231

Interoperability endpoints

  • Direct secure messaging: shannon.haenel.p1@direct.wilmingtonhealth.nextgenshare.com

Organizations & group practices 11

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 11

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": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1811124365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-341-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 SILVER STREAM LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017684",
            "telephone_number": "910-341-3453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAENEL",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-11",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10034619",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "KS",
            "license": "05-38452",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OK",
            "license": "6314",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "2023-03041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.