DR. MICHAEL CAROLL SHANNON (NPI# 1164531497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164531497 |
Entity Type | Individual |
Full Name | DR. MICHAEL CAROLL SHANNON |
Credential | MD |
Practice Address |
1101 Madison St Ste 800 Swedish Pediatric Specialty Care Seattle WA 98104-1307 |
Practice Telephone | 2062152700 |
Practice Fax Number | 2062152702 |
Mailing Telephone | 2062152700 |
Mailing Fax Number | 2062152702 |
Enumeration Date | 2006-08-30 |
Last Update Date | 2013-08-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
MD60096471 | WA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | 8549958 | 05 | |
NM | L6647 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235762345 | Michael E Shannon | Private Vehicle | 7928 Brown Mountain Rd, Jewell Ridge, VA 24622-8640 | 2020-02-17 |
1578005898 | Michael J. Shannon | Hearing Instrument Specialist | 4911 Warner Ave # 217, Huntington Beach, CA 92649-5177 | 2016-11-17 |
1538461520 | Michael Anthony Shannon | Home Health Aide | 4821 Highway 19 W, Bryson City, NC 28713-8575 | 2010-11-23 |
1629301486 | Michael Shannon | Rehabilitation Practitioner | 13457 Vanowen St, Van Nuys, CA 91405-4385 | 2009-09-11 |
1326225160 | Michael James Shannon | Radiology | 702 Brougham Ln, Oak Brook, IL 60523-2677 | 2008-01-23 |
1912103946 | Michael Shannon | Dentist | 13360 Coursey Blvd Ste D, Baton Rouge, LA 70816-4970 | 2007-06-26 |
1467542852 | Michael E Shannon | Dentist | 800 N Center Pkwy, Kennewick, WA 99336-7118 | 2006-10-13 |
1538119607 | Michael Brendan Shannon | Internal Medicine | 325 9th Ave # 359606, Seattle, WA 98104-2420 | 2006-05-11 |
1043210727 | Michael B Shannon | Neurological Surgery | 2809 Bell St, Zanesville, OH 43701-2861 | 2005-07-26 |
1871105213 | Michael Shannon | Licensed Practical Nurse | 1015 E 6th Ave, Anchorage, AK 99501-2748 | 2020-08-18 |
Street Address |
1101 MADISON ST STE 800 SWEDISH PEDIATRIC SPECIALTY CARE |
City | SEATTLE |
State | WA |
Zip Code | 98104-1307 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275599631 | John Pilgrim Osborn | Pediatrics | 1101 Madison St Ste 800, Seattle, WA 98104-1306 | 2006-04-25 |
1073064473 | Brynn Fuller | Specialist/Technologist | 1101 Madison St Ste 800, Seattle, WA 98104-1307 | 2016-10-20 |
1043636194 | Danielle M Magrini | Pediatrics | 1101 Madison St Ste 800, Seattle, WA 98104-1307 | 2014-03-13 |
1265722789 | Ranita Sana Patel | Pediatrics | 1101 Madison St Ste 800, Seattle, WA 98104-1307 | 2011-04-18 |
1902034028 | Cindy Chunshin Tai | Surgery | 1101 Madison St Ste 800, Seattle, WA 98104-1307 | 2009-06-26 |
1376787366 | Richy Lee | Surgery | 1101 Madison St Ste 800, Seattle, WA 98104 | 2009-04-22 |
1578753802 | Dinesh Thekke Karumathil | Pediatrics | 1101 Madison St Ste 800, Seattle, WA 98104-1307 | 2007-08-01 |
1235200239 | Gregory K. Sorensen | Pediatrics | 1101 Madison St Ste 800, Seattle, WA 98104-1307 | 2006-11-13 |
1144391145 | Laurie S. Fouser | Transplant Surgery | 1101 Madison St Ste 800, Seattle, WA 98104-1307 | 2006-11-13 |
1053482059 | Thomas N. Swanson | Pediatrics | 1101 Madison St Ste 800, Seattle, WA 98104-1307 | 2006-11-13 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699394312 | Richard Charles Harruff | Pathology | King County Medical Examiners Office, 325 Ninth Avenue, Seattle, WA 98104 | 2020-04-13 |
1558999474 | Nathan Richard Benner | Student in an Organized Health Care Education/Training Program | Uw Medicine-harborview Medical Center Orthopaedics, 325 Ninth Avenue, Seattle, WA 98104 | 2020-03-27 |
1063058493 | Brook, LLC. | Health Educator | 311 1/2 Occidental Ave South, Suite 210, Seattle, WA 98104 | 2019-11-20 |
1609418813 | Stephanie Amanda Ann Mason | Student in an Organized Health Care Education/Training Program | 325 9th Avenue, Mail Stop #359796, Seattle, WA 98104 | 2019-10-09 |
1013480250 | Robert Kenneth Lozier | Pedorthist | Norm Maleng Building, 410 9th Ave, 4th Floor, Seattle, WA 98104 | 2019-01-10 |
1548739576 | Lee Hanses | Physical Therapist | 1124 Columbia Street, Level P1, Suite P100, Seattle, WA 98104 | 2018-11-20 |
1821579095 | Karissa Lin Lee | Pharmacist | 401 Broadway #2075, Seattle, WA 98104 | 2018-08-27 |
1477042091 | Maham Jehangir | Student in an Organized Health Care Education/Training Program | 325 9th Ave Department of Radiology, Seattle, WA 98104 | 2018-05-09 |
1740786581 | Philip Daniel Tolley | Student in an Organized Health Care Education/Training Program | 325 9th Ave. Mail Stop#359796, 7th Floor Center Tower Rm #73.1, Seattle, WA 98104 | 2018-04-02 |
1528564242 | Vanessa Dawn Leonhard | Student in an Organized Health Care Education/Training Program | 325 9th Ave, 7th Floor Center Tower Room 73.1, Mail Stop #359796, Seattle, WA 98104 | 2018-04-02 |
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Taxonomy Code | 2080P0203X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
Specialization | Pediatric Critical Care Medicine |
A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306378278 | Pliceliany Perez | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2017-03-30 |
1710276761 | Emily Berkman | Pediatrics | 4800 Sand Point Way Ne, A-5950, Seattle, WA 98105 | 2011-03-30 |
1003077025 | Leslie Ann Dervan | Pediatrics | 4800 Sand Point Way Ne, Mb.10.620, Seattle, WA 98105-3901 | 2008-06-23 |
1861651929 | Silvia Hartmann | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2008-06-04 |
1538338975 | Amelie Olga-marie Von Saint Andre - Von Arnim | Pediatrics | 4800 Sand Point Way Ne, M/s W-8866, Seattle, WA 98105-3901 | 2008-02-28 |
1508921024 | Ofer Yanay | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2006-12-26 |
1275607913 | Thomas V. Brogan | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2006-11-17 |
1972672491 | Kenneth A Schenkman | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2006-11-07 |
1841376522 | Harris P Baden | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2006-10-27 |
1730265414 | David S Jardine | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2006-10-27 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.