Individual provider Active NPI

Shawn Patrick McMahon, M.D.

  • Family Medicine Physician
  • Two Harbors, MN
National Provider Identifier
1871528646
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33589 Issued in MN
Practice address
325 11TH Ave
Two Harbors, MN 55616-1300
Phone
(218) 834-7727
Fax
(218) 834-7727
NPI assigned
Jul 11, 2006
Last updated
Oct 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33589 MN Primary

Addresses

Primary practice location

325 11TH Ave
Two Harbors, MN 55616-1300

Mailing address

325 11TH Ave
Two Harbors, MN 55616-1300
Phone (218) 834-7727

Other identifiers 1

IdentifierTypeStateIssuer
336702900MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@lkv.direct.slhduluth.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060220000338 MN Practitioner - Family Practice 4789586439 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake View Memorial Hospital, Inc Current Accepting new patients
Lake View Memorial Hospital, Inc CurrentSince Jul 7, 2008 Accepting new patients
Lake View Memorial Hospital, Inc. CurrentSince Jul 7, 2008 Accepting new patients
The Duluth Clinic, LTD. Past Accepting new patients
Firstsolutions Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1010 4th St
Two Harbors, MN 55616
Phone (218) 724-3083

325 11th Ave
Two Harbors, MN 55616
Phone (218) 834-5520

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1871528646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 11TH AVE",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556161300",
            "telephone_number": "218-834-7727",
            "fax_number": "218-834-7727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 11TH AVE",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556161300",
            "telephone_number": "218-834-7727",
            "fax_number": "218-834-7727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "SHAWN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "33589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336702900",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@lkv.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "1010 4th St",
            "city": "Two Harbors",
            "state": "MN",
            "country_code": "US",
            "postal_code": "556161200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Two Harbors, MN

Sources for this page

Verify at the official NPI Registry.