NPIMap

Organization Active NPI

Shannon Medical Center

  • General Acute Care Hospital
  • San Angelo, TX
National Provider Identifier
1992707228
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
168 Issued in TX
Legal business name
SHANNON MEDICAL CENTER
Practice address
120 E Harris Ave
San Angelo, TX 76903-5904
Phone
(325) 653-6741
NPI assigned
May 31, 2005
Last updated
Jun 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Authorized official

Name
Miss Patricia Kirkham
Title
Billing Supervisor
Phone
(325) 657-5031

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X
General Acute Care Hospital 282N00000X 168 TX Primary

Addresses

Primary practice location

120 E Harris Ave
San Angelo, TX 76903-5904

Mailing address

PO Box 1879
San Angelo, TX 76902-1879
Phone (325) 657-6741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030702000024 TX Part A Provider - Hospital 2860302767 Practice locations: San Angelo, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992707228. Details of each certification follow.

Hospital certification: CCN 450571

Legal name
SHANNON MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Sep 10, 1968
Last certification
Aug 25, 2023
Beds
616
Ownership / control type
Private (not for profit)
Most recent change of ownership
Sep 17, 2024 (2 total)
Organization structure
CorporationNon-profit
Incorporated
Aug 24, 1994 in TX
Enrollment address
120 E Harris Ave
San Angelo, TX 76903-5904
Main/Primary Hospital Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Shannon Medical CenterCCN 450571 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
James a Boyd Individual Corporate Director Oct 1, 2021
Leonard Mertz Individual Corporate Director Jan 1, 1998
Amado M Castillo Individual Corporate Director Oct 1, 2021
Oran Berry Individual Corporate Director Jan 8, 2004
Shannon Health System Organization, San Angelo, TX Non-profit 5% Or Greater Direct Ownership Interest Apr 6, 1995 100%
Martha Visney Individual Corporate Director Oct 1, 2021
Michael Weatherford Individual Corporate DirectorBoard Member Jan 1, 2017
Shannon West Texas Memorial Hospital Organization, San Angelo, TX Non-profit 5% Or Greater Indirect Ownership Interest Apr 6, 1995 100%
Michael Oliphant Individual Corporate Director Aug 6, 2007
Ross a Harper Individual Corporate DirectorBoard Member Oct 1, 2022
Jeffrey G McCormick Individual Corporate DirectorBoard Member Oct 1, 2020
Kelly Plymell Individual Corporate OfficerCeo Jan 1, 2017
Corporate Director Jan 1, 2017
W-2 Managing EmployeeCeo Jan 1, 2017
Rudy Haddad Individual Corporate DirectorBoard Member Oct 1, 2025
Joseph Wooldridge Individual Corporate OfficerCfo May 16, 2019
W-2 Managing Employee May 16, 2019
William C Griffis Individual Corporate Director Oct 1, 2020
John Cecil Individual Corporate Director Oct 1, 2007
Freddy L Moore Individual Corporate Director Jun 1, 2020

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Family Health Center of OzonaOzona, TX, CCN 673841 Rural health clinic Operational/Managerial Control Jan 1, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 70

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 70

Affiliated clinicians 519

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 519

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1992707228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1879",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769021879",
            "telephone_number": "325-657-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E HARRIS AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035904",
            "telephone_number": "325-653-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "KIRKHAM",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "325-657-5031",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TX",
            "license": "168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.