Shannon Marie Brown, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601003706 Issued in MI

Practice address

5515 Cleveland Ave
Suite 5
Stevensville, MI 49127-9670

Phone

(269) 429-9644

Fax

(269) 429-4002

NPI assigned

Jun 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sbrown255020@epic00.corewelldirect.org
• Direct secure messaging: sbrown3173@lakeland.midirect.net

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.

• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Saint Joseph, MI
  • NPI 1538397120
  Medicare reassignment Care Compare group NPD (past)
• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Bridgman, MI
  • NPI 1568232247
  NPD

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363219200000",
    "number": "1821027269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5515 CLEVELAND AVE",
            "address_2": "SUITE 5",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279670",
            "telephone_number": "269-429-9644",
            "fax_number": "269-429-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 CLEVELAND AVE",
            "address_2": "SUITE 5",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279670",
            "telephone_number": "269-429-9644",
            "fax_number": "269-429-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2013-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970023780",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Beilman
• Berrien County Cancer Service Inc
• Stephanie Blommel, OTR/L
• Lynda Sue Bredeweg, LMSW
• Bridgman Psychological Partners PLC
• Sandra Brueck
• James Burch
• Kimberle Capes, PHARM.D., RPH
• Barbara S Carlson, M.D.
• Brandon Robert Cole, DO

• Physician Assistant in Stevensville, MI
• Providers in Stevensville, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.