Individual provider Active NPI

Michael Shannon Todd, DO

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Anderson, IN
National Provider Identifier
1922158997
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
02002715A Issued in IN
Practice address
3125 S Scatterfield Rd Ste 210
Anderson, IN 46013
Phone
(765) 298-4311
Fax
(765) 298-4312
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 02002715A IN
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 02002715A IN Primary

Addresses

Primary practice location

3125 S Scatterfield Rd Ste 210
Anderson, IN 46013

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other identifiers 1

IdentifierTypeStateIssuer
300014911MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mtodd319478@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20180623000189 IN Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 5496812430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Ohio University, College of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians
US Therapy IncGroup PAC ID 6507893187, 81 clinicians

Practice addresses (Care Compare)

3125 S Scatterfield Rd
Suite 210
Anderson, IN 46013-1804
Phone (317) 355-2663

3607 N Everbrook LN
Muncie, IN 47304-5220

Hospital & facility affiliations

  • Community Health at Home LLC Home health agency, Indianapolis, IN, CCN 157046
  • Community Hospital of Anderson and Madison County Hospital, Anderson, IN, CCN 150113
  • Community Hospital North Hospital, Indianapolis, IN, CCN 150169

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement24
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02002715AINMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Aug 13, 2018 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Aug 13, 2018 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

3125 S Scatterfield Rd
Ste 210
Anderson, IN 46013
Phone (765) 298-4311

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

Interoperability endpoints

  • Direct secure messaging: mtodd319478@ecommunitydirect.com

Organizations & group practices 3

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 3

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1922158997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 S SCATTERFIELD RD STE 210",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "46013",
            "telephone_number": "765-298-4311",
            "fax_number": "765-298-4312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "MICHAEL",
        "middle_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "02002715A",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IN",
            "license": "02002715A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300014911",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtodd319478@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "3125 S Scatterfield Rd Ste 210",
            "city": "Anderson",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.