Brian M Shannon, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00412700 Issued in NJ

Practice address

260 Godwin Ave
Suite 1
Wyckoff, NJ 07481-5200

Phone

(201) 891-1155

Fax

(201) 891-5522

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Total Body Rehabilitation LLC

  • Chiropractor
  • Wyckoff, NJ
  • NPI 1336338581
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942352877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 GODWIN AVE",
            "address_2": "SUITE 1",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074815200",
            "telephone_number": "201-891-1155",
            "fax_number": "201-891-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 GODWIN AVE",
            "address_2": "SUITE 1",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074815200",
            "telephone_number": "201-891-1155",
            "fax_number": "201-891-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "BRIAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00412700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Schluger, MS/OTR
• Kenneth Albert Schmidt, M.D.
• Olivia Schutz, LAC
• Peter Schwartz
• Negar Sedaghat-Ardakani, O.D.
• Susan Beth Sharron, LCSW
• Li Ching Sheng, PHARMD
• Tina M. Sherry, PSY.D.
• Alanna Shinske
• Zoya Shir, NP

• Chiropractor in Wyckoff, NJ
• Providers in Wyckoff, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.