Shannon Wild

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Practice address

1110 Catalpa Dr
Royal Oak, MI 48067-1125

Phone

(248) 971-0383

NPI assigned

Apr 27, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335484800000",
    "number": "1861750747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37690 CHARTER OAKS BLVD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480362424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 CATALPA DR",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671125",
            "telephone_number": "248-971-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-27",
        "last_updated": "2012-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan M Wigg, MS OTR/L
• Betty J Wilborn-Lee, LMSW
• Henrietta Carter Wilcox, LCSW
• Jennie A Wilcox, LLMSW
• Thomas Wilczewski
• Sarah Zukowski Wilhelm, P.A.-C
• Meghan Wilk, CPNP-PC
• Jariyon Wendell Wilkens
• Keith Wilkinson, MD
• Todd Wilkinson, MD

• Community/Behavioral Health Agency in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2012; 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.