NPIMap

Individual provider Active NPI

Shannon Harris Vanantwerp, PA-C

  • Physician Assistant
  • Billings, MT
National Provider Identifier
1902523905
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MED-PAC-LIC-117108 Issued in MT
Practice address
760 Wicks LN
Billings, MT 59105-4427
Phone
(406) 238-2900
NPI assigned
Oct 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MED-PAC-LIC-117108 MT Primary

Addresses

Primary practice location

760 Wicks LN
Billings, MT 59105-4427

Mailing address

PO Box 35100
Billings, MT 59107-5100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sharris8@billingsclinic.cernerdirect.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230103000961 MT Practitioner - Physician Assistant 3678943982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Billings ClinicGroup PAC ID 6002993516, 814 clinicians

Practice addresses (Care Compare)

2675 Central Ave
Billings, MT 59102-6686
Phone (406) 238-2500

2800 10TH Ave N
Billings, MT 59101-0703
Phone (406) 657-4000

760 Wicks Lane
Billings, MT 59105-4427
Phone (406) 238-2501

Hospital & facility affiliations

  • Billings Clinic Hospital Hospital, Billings, MT, CCN 270004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Billings Clinic CurrentSince Dec 12, 2022 Accepting new patients
Billings Clinic CurrentSince Dec 12, 2022 Accepting new patients

Locations

2675 Central Ave
Billings, MT 59102
Phone (406) 238-2900

760 Wicks Ln
Billings, MT 59105
Phone (406) 238-2475

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

Interoperability endpoints

  • Direct secure messaging: sharris8@billingsclinic.cernerdirect.com

Organizations & group practices 8

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1902523905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35100",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591075100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WICKS LN",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591054427",
            "telephone_number": "406-238-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANANTWERP",
        "first_name": "SHANNON",
        "middle_name": "HARRIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-20",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "MED-PAC-LIC-117108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sharris8@billingsclinic.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2675 Central Ave",
            "city": "Billings",
            "state": "MT",
            "country_code": "US",
            "postal_code": "591026686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.