Individual provider Active NPI

Shannon L. Stevenson, DO

  • Internal Medicine Physician
  • Hilliard, OH
National Provider Identifier
1922368331
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34013697 Issued in OH
Practice address
3691 Ridge Mill Dr
Hilliard, OH 43026
Phone
(614) 688-9220
Fax
(614) 688-9177
NPI assigned
May 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 02004854A IN
Internal Medicine Physician 207R00000X 02004854A IN
Pediatrics Physician 208000000X 5101019944 MI
Internal Medicine Physician 207R00000X 34013697 OH Primary

Addresses

Primary practice location

3691 Ridge Mill Dr
Hilliard, OH 43026

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-5123

Other identifiers 1

IdentifierTypeStateIssuer
0336853MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sstevenson676811@direct.osumc.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190326002535 OH Practitioner - Internal MedicinePractitioner - Pediatric Medicine 4981835394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Internal Medicine LLCGroup PAC ID 5496651408, 1,141 clinicians

Practice addresses (Care Compare)

452 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8000

Hospital & facility affiliations

  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02004854AINMDInternal Medicine Physician
34013697OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Internal Medicine, LLC Internal Medicine CurrentSince Dec 1, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2050 Kenny Rd
Columbus, OH 43221
Phone (614) 293-8054

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

700 Ackerman Rd
Ste 570
Columbus, OH 43202
Phone (614) 293-2046

452 W 10th Ave
Columbus, OH 43210

3900 Stoneridge Ln
Dublin, OH 43017
Phone (614) 366-5001

3691 Ridge Mill Dr
Hilliard, OH 43026
Phone (614) 685-3333

Interoperability endpoints

  • Direct secure messaging: shannon.stevenson.1@19222.direct.athenahealth.com

Organizations & group practices 2

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": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1922368331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3691 RIDGE MILL DR",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "43026",
            "telephone_number": "614-688-9220",
            "fax_number": "614-688-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "SHANNON",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-18",
        "last_updated": "2023-11-14",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "02004854A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02004854A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101019944",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34013697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0336853",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sstevenson676811@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "3691 Ridge Mill Dr",
            "city": "Hilliard",
            "state": "OH",
            "country_code": "US",
            "postal_code": "43026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hilliard, OH

Sources for this page

Verify at the official NPI Registry.