SHANNON MARIE FAGAN (NPI# 1235743212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235743212 |
| Entity Type | Individual |
| Full Name | SHANNON MARIE FAGAN |
| Credential | PT, DPT |
| Practice Address |
449 Quarter St Gladwin MI 48624-1918 |
| Mailing Address |
4644 Babcock Rd Lexington MI 48450-9531 |
| Practice Telephone | 9894263430 |
| Mailing Telephone | 8107121377 |
| Enumeration Date | 2020-09-07 |
| Last Update Date | 2020-09-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | 5501019728 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649537531 | Shannon Travis Fagan | Nurse Practitioner | 2000 6th Ave S, Birmingham, AL 35233-2110 | 2012-04-16 |
| Street Address |
449 QUARTER ST |
| City | GLADWIN |
| State | MI |
| Zip Code | 48624-1918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447298849 | Midmichigan Gladwin Pines | Skilled Nursing Facility | 449 Quarter St, Gladwin, MI 48624-1918 | 2006-06-04 |
| 1568009959 | Renee Michele Lang | Physical Therapy Assistant | 449 Quarter St, Gladwin, MI 48624-1918 | 2019-12-04 |
| 1376009381 | Nancy C Dodge | Physical Therapist | 449 Quarter St, Gladwin, MI 48624-1918 | 2019-02-14 |
| 1104303023 | Maria Johanna Ruffer | Occupational Therapist | 449 Quarter St, Gladwin, MI 48624-1918 | 2018-07-24 |
| 1184073397 | Gladwin Pines Operating, LLC | Skilled Nursing Facility | 449 Quarter St, Gladwin, MI 48624-1918 | 2016-06-08 |
| 1396103180 | Gladwin Pines Operating, LLC | Skilled Nursing Facility | 449 Quarter St, Gladwin, MI 48624-1918 | 2016-02-08 |
| 1174865273 | Midmichigan Gladwin Pines | Skilled Nursing Facility | 449 Quarter St, Gladwin, MI 48624-1918 | 2013-03-27 |
| 1730451311 | Jessica Sue Beach | Occupational Therapist | 449 Quarter St, Gladwin, MI 48624-1918 | 2012-01-30 |
| 1346552775 | Puneet Kaur Pandher | Physical Therapist | 449 Quarter St, Gladwin, MI 48624-1918 | 2010-07-14 |
| 1578894275 | Kathleen Lynn Martini | Physical Therapy Assistant | 449 Quarter St, Gladwin, MI 48624-1918 | 2010-01-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558889162 | Jacob Cameron Shell | Specialist/Technologist | 4403 Betty Lee Blvd, Gladwin, MI 48624 | 2017-09-03 |
| 1750704268 | Monica Maebel Weaver | Licensed Practical Nurse | 1426 North St. Street, Affordable Nursing Inc, Gladwin, MI 48624 | 2014-02-04 |
| 1417397407 | Richard Allen White | Registered Nurse | 655 East Cedar Avenue, Gladwin, MI 48624 | 2013-07-05 |
| 1023453040 | Amy Rebecca Brockschmidt | Counselor | Ten16 Recovery Network, 1302 Chatterton St. 2, Gladwin, MI 48624 | 2013-05-03 |
| 1447558341 | Erika Dianis | Psychologist | 655 E. Cedar Ave., Gladwin, MI 48624 | 2011-03-02 |
| 1457519456 | Bont & Medical Products Inc | Durable Medical Equipment & Medical Supplies | 895 N M18 Suite 2, Gladwin, MI 48624 | 2008-05-27 |
| 1346424454 | Regional Dialysis Services Inc | Clinic/Center | 673 Quarter Street, Gladwin, MI 48624 | 2007-12-26 |
| 1548476070 | Sambamurti . Srinivasan | Family Medicine | 602 Riverview Ct, Gladwin, MI 48624 | 2007-05-14 |
| 1295957850 | Midmichigan Visiting Nurse Association | Durable Medical Equipment & Medical Supplies | 1234 W Cedar Ave, Gladwin, MI 48624 | 2007-05-03 |
| 1710063755 | Janet Flynn | Registered Nurse | 1207 N Spring St, Gladwin, MI 48624 | 2006-10-31 |
| Find all providers in zip 48624 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629392543 | Utkarsh Jayantilal Patel | Physical Therapist | 669 E Cedar Ave, Gladwin, MI 48624-2215 | 2010-03-22 |
| 1861518508 | Kamal Kishore Kashyap | Physical Therapist | 3200 Pratt Lake Rd, Gladwin, MI 48624-8901 | 2007-03-22 |
| 1346848140 | Chelsea Hutchinson | Physical Therapist | 609 Quarter St, Gladwin, MI 48624-1941 | 2020-10-14 |
| 1376009381 | Nancy C Dodge | Physical Therapist | 449 Quarter St, Gladwin, MI 48624-1918 | 2019-02-14 |
| 1598168064 | Kristi L Owens | Physical Therapist | 1206 N State St, Gladwin, MI 48624-1246 | 2014-09-29 |
| 1346552775 | Puneet Kaur Pandher | Physical Therapist | 449 Quarter St, Gladwin, MI 48624-1918 | 2010-07-14 |
| 1972735728 | Ushasri Subbarao Kotipalli | Physical Therapist | 449 Quarter St, Gladwin, MI 48624-1918 | 2009-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316548589 | Dipal Patel | Physical Therapist | 4063 Pond Run, Canton, MI 48188-2176 | 2020-11-04 |
| 1215538855 | No Limits Physical Therapy | Physical Therapist | 36223 Ladywood St, Livonia, MI 48154-2027 | 2020-11-02 |
| 1487254322 | Kelsey Renee Fischer | Physical Therapist | 8111 S State Rd, Goodrich, MI 48438-8946 | 2020-10-29 |
| 1457951493 | Wellness and Movement Transformation | Physical Therapist | 1276 Long Lake Ct, Brighton, MI 48114-9640 | 2020-10-29 |
| 1851991392 | Daniel Paul Swanson | Physical Therapist | 2849 Michigan St Ne Ste 100, Grand Rapids, MI 49506-1216 | 2020-10-26 |
| 1215536040 | Wholistic Physical Therapy Clinic | Physical Therapist | 4197 E Grand River Ave, Howell, MI 48843-8523 | 2020-10-22 |
| 1922607183 | Brian Glenn Mccarroll | Physical Therapist | 14626 23 Mile Rd, Shelby Township, MI 48315-3000 | 2020-10-20 |
| 1598364846 | Jenna Schra | Physical Therapist | 12723 N Bellwood Dr Ste 10, Holland, MI 49424-7275 | 2020-10-19 |
| 1396343596 | Athletico Ltd | Physical Therapist | 2090 W Grand River Ave Ste C, Okemos, MI 48864-1773 | 2020-10-12 |
| 1538767728 | Allen Physical Therapy Novi LLC | Physical Therapist | 26850 Providence Pkwy Ste 400, Novi, MI 48374-1263 | 2020-10-11 |
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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.