Active NPI
Shannon Taylor Ingwersen, M.D.
- Obstetrics Physician
- Melbourne, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics Physician
- License
- ME149728
- Practice address
- 330 E Hibiscus Blvd
Melbourne, FL 32901-3155 - Phone
- (321) 724-2229
- Fax
- (321) 728-6668
- NPI assigned
- Apr 3, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Obstetrics & Gynecology Physician | 207V00000X | DR.0056592 | CO | |
| Obstetrics Physician | 207VX0000X | ME149728 | FL | Primary |
Addresses
Primary practice location
330 E Hibiscus Blvd
Melbourne, FL 32901-3155
Mailing address
330 E Hibiscus Blvd
Melbourne, FL 32901-3155
Phone (321) 724-2229
Other practice location 1
2 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 821-8038
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | singwersen266457@direct.tgh.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160917000339 | CO | Practitioner - Obstetrics/Gynecology | 2860789914 | |
| I20240402002151 | WA | Practitioner - Obstetrics/Gynecology | 2860789914 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 87.1 of 100
- Quality
- 84.53
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.46
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swedish Health Services | Obstetrics & Gynecology | Current | Accepting new patients |
| Portercare Adventist Health System | Current | Accepting new patients | |
| Portercare Adventist Health System | Current | Accepting new patients | |
| Portercare Adventist Health System | Current | Accepting new patients |
Locations
15901 E Briarwood Cir
Unit 200
Aurora, CO 80016
Phone (303) 269-2626
7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650
9397 Crown Crest Blvd
Ste 220
Parker, CO 80138
Phone (303) 721-1670
7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800
751 NE Blakely Dr
Ste 2030
Issaquah, WA 98029
Phone (425) 313-4141
747 Broadway
Seattle, WA 98122
Phone (360) 658-2488
Interoperability endpoints
- singwersen266457@direct.tgh.org
- singwersen3208131@wm.providencedirect.org
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Seattle, WA
- NPI 1689612954
Obstetrics & Gynecology, WA
-
- Otolaryngology Physician
- Greenwood Village, CO
- NPI 1760761928
-
- Urology Physician
- Lakewood, CO
- NPI 1942165626
-
- Family Medicine Physician
- Aurora, CO
- NPI 1992316947
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689033600000",
"number": "1902162019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 E HIBISCUS BLVD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329013155",
"telephone_number": "321-724-2229",
"fax_number": "321-728-6681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 E HIBISCUS BLVD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329013155",
"telephone_number": "321-724-2229",
"fax_number": "321-728-6668"
}
],
"practiceLocations": [
{
"address_1": "2 Tampa General Cir",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336063571",
"country_code": "US",
"telephone_number": "813-821-8038",
"fax_number": "813-974-4325",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "INGWERSEN",
"first_name": "SHANNON",
"middle_name": "TAYLOR",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-03",
"last_updated": "2023-07-11",
"certification_date": "2023-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "CO",
"license": "DR.0056592",
"primary": false
},
{
"code": "207VX0000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Obstetrics",
"state": "FL",
"license": "ME149728",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "singwersen266457@direct.tgh.org",
"affiliation": "N",
"address_1": "2 Tampa General Cir",
"city": "Tampa",
"state": "FL",
"country_code": "US",
"postal_code": "336063571",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.