Michael Shannon, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

152821 Issued in AK

Practice address

1015 E 6TH Ave
Anchorage, AK 99501-2748

Phone

(907) 276-6430

NPI assigned

Aug 18, 2020

Last updated

Aug 18, 2020By the provider in NPPES

Sex

Male

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

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Revive Infusion Clinic, LLC

  • Infusion Therapy Clinic/Center
  • Eagle River, AK
  • NPI 1457226789
  NPD Authorized official
• Bonner General Hospital, Inc.

  dba Bonner Community Hospice

  • Community Based Hospice Care Agency
  • Sandpoint, ID
  • NPI 1073562591
  NPD (past)

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1871105213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 E 6TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995012748",
            "telephone_number": "907-276-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 E 6TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995012748",
            "telephone_number": "907-276-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "MICHAEL",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AK",
            "license": "152821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Candid Alaska, P.C.
• Alexandra Ilona Shannon, OTD
• Charles Roy Shannon, MD
• John P Shannon Jr., D.C.
• Mary Hogg Shannon, PA
• Shared Purpose LLC
• Kimberly Sharkey, CNA
• Sharon Lake Counseling
• Sharon's Assisted Living, LLC
• Alexandria Darnae Sharp-McCormick, M.S., CCC-SLP

• Licensed Practical Nurse in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Licensed Practical Nurse in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.