Active NPI
Melinda Amber Shannon, PT. DPT, MS
- Physical Therapist
- Coloma, MI
National Provider Identifier
1942770698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501018442
- Practice address
- 7040 Red Arrow Hwy
Coloma, MI 49038-8720 - Phone
- (269) 468-4316
- NPI assigned
- Nov 26, 2018
- Last updated
- Nov 26, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501018442 | MI | Primary |
Addresses
Primary practice location
7040 Red Arrow Hwy
Coloma, MI 49038-8720
Mailing address
7040 Red Arrow Hwy
Coloma, MI 49038-8720
Phone (269) 468-4316
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501018442 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543190400000",
"number": "1942770698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7040 RED ARROW HWY",
"city": "COLOMA",
"state": "MI",
"postal_code": "490388720",
"telephone_number": "269-468-4316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7040 RED ARROW HWY",
"city": "COLOMA",
"state": "MI",
"postal_code": "490388720",
"telephone_number": "269-468-4316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANNON",
"first_name": "MELINDA",
"middle_name": "AMBER",
"credential": "PT. DPT, MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-26",
"last_updated": "2018-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501018442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coloma, MI
- Rite Aid of Michigan Inc (Rite Aid Pharmacy 04239)
- Shanna R Rodgers, MA
- Jaime Rodriguez, M.D.
- Ruth Lee Center for Healing and Growth
- Shafee Ahamad Shaik
- Jeremy B Shelley, PT
- Faith Shreve, LMSW
- Southwest Michigan Center for Orthopaedics and Sports Medicine
- Southwest Michigan Home Care Services, Inc
- Ashley R Stacker, LMSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.