DR. SHANNON M WILLS (NPI# 1750717328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750717328 |
| Entity Type | Individual |
| Full Name | DR. SHANNON M WILLS |
| Credential | PHD, MS, PA-C |
| Practice Address |
3577 W 13 Mile Rd Ste 404 Royal Oak MI 48073-6710 |
| Practice Telephone | 2485516900 |
| Practice Fax Number | 2485516909 |
| Mailing Telephone | 2485516900 |
| Mailing Fax Number | 2485516909 |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2013-09-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601006762 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306297478 | Shannon Wills | Student in an Organized Health Care Education/Training Program | 3990 Old Town Ave Ste C201, San Diego, CA 92110-2933 | 2016-06-29 |
| Street Address |
3577 W 13 MILE RD STE 404 |
| City | ROYAL OAK |
| State | MI |
| Zip Code | 48073-6710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285634857 | Kurt Harrison Neumann | Internal Medicine | 3577 W 13 Mile Rd, Suite 103, Royal Oak, MI 48073-6710 | 2005-07-26 |
| 1396303954 | Lauren Robin Bliss | Physician Assistant | 3577 W 13 Mile Rd, Royal Oak, MI 48073-6710 | 2019-05-30 |
| 1982144150 | Chelsea Foster | Physician Assistant | 3577 W 13 Mile Rd, Suite 204, Royal Oak, MI 48073-6710 | 2017-03-07 |
| 1891232278 | Amy Copeland | Physician Assistant | 3577 W 13 Mile Rd, Suite 103, Royal Oak, MI 48073-6710 | 2017-01-24 |
| 1497129860 | Michelle Rie Okada | Physician Assistant | 3577 W 13 Mile Rd, Ste. 103, Royal Oak, MI 48073-6710 | 2015-11-22 |
| 1982022703 | Carla Phillips | Nurse Practitioner | 3577 W 13 Mile Rd, Royal Oak, MI 48073-6710 | 2014-03-29 |
| 1639592041 | Karen Macdonald | Nurse Practitioner | 3577 W 13 Mile Rd, Beaumont Pediatric Hematology/oncology, Royal Oak, MI 48073-6710 | 2014-01-22 |
| 1104255496 | Lauren Goedtel | Physician Assistant | 3577 W 13 Mile Rd, Ste 103, Royal Oak, MI 48073-6710 | 2013-11-06 |
| 1245593110 | Tiffany Rechandra Johnson | Nurse Practitioner | 3577 W 13 Mile Rd, Royal Oak, MI 48073-6710 | 2012-06-16 |
| 1578843629 | Michigan Healthcare Professionals PC | Durable Medical Equipment & Medical Supplies | 3577 W 13 Mile Rd, Suite 204, Royal Oak, MI 48073-6710 | 2011-08-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891306114 | Spine and Joint Surgical Institute of Michigan, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 200, Royal Oak, MI 48073 | 2020-08-11 |
| 1528679081 | Activo Physical Therapy, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 101, Royal Oak, MI 48073 | 2020-08-10 |
| 1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
| 1598389785 | Devika Aggarwal | Internal Medicine | 3601 W 13 Mile Road Beaumont Hospital- Royal Oak, Royal Oak, MI 48073 | 2020-06-03 |
| 1831713064 | Michael Morelli | Physical Medicine & Rehabilitation | Department of Physical Medicine and Rehabilitation, 3601 W 13 Mile Road, Royal Oak, MI 48073 | 2020-06-03 |
| 1134741895 | Kamil Sardarli | Internal Medicine | Beaumont Hospital - Royal Oak 3601 W Thirteen Mile Road, Royal Oak, MI 48073 | 2020-05-15 |
| 1245850171 | Dema Fawaz | Emergency Medicine | Beaumont Hospital, Royal Oak, Gme Office, 3601 W. 13 Mile Rd, Royal Oak, MI 48073 | 2020-04-21 |
| 1235771049 | Semaan Dentistry Pllc | Dentist | 30955 Woodward Ave Ste 105, Royal Oak, MI 48073 | 2019-10-14 |
| 1013560473 | Muhammad Waqas | Pediatrics | Beaumont Hospital Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI 48073 | 2019-07-24 |
| 1346804135 | Matthew M Astolfi | Orthopaedic Surgery | 3601 W Thirteenth Mile Road, Royal Oak, MI 48073 | 2019-04-26 |
| Find all providers in zip 48073 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720483670 | Tricia Campbell | Physician Assistant | 605 Helene Ave, Royal Oak, MI 48067 | 2014-11-04 |
| 1578973657 | Malisa M Burt | Physician Assistant | 127 Forest Ave, Royal Oak, MI 48067-1843 | 2014-04-29 |
| 1023130853 | Mobile Medical Consultant Pllc | Physician Assistant | 620 S Dorchester Ave, Royal Oak, MI 48067-4048 | 2007-04-04 |
| 1851493241 | Angeline A Carter | Physician Assistant | 2674 Bembridge Rd, Royal Oak, MI 48073-2921 | 2006-09-05 |
| 1922094689 | Kenneth Wayne Gahry | Physician Assistant | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2005-09-27 |
| 1902443047 | Brad Vamplew | Physician Assistant | 31157 Woodward Ave, Royal Oak, MI 48073-0996 | 2019-12-09 |
| 1770124208 | Ashley Meerschaert | Physician Assistant | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2019-10-07 |
| 1871058065 | Zeinab Joumaa Naji | Physician Assistant | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2019-02-01 |
| 1497269781 | Kristin Joy Welbourn | Physician Assistant | 3600 W 13 Mile Rd, Royal Oak, MI 48073-6711 | 2017-11-22 |
| 1982144150 | Chelsea Foster | Physician Assistant | 3577 W 13 Mile Rd, Suite 204, Royal Oak, MI 48073-6710 | 2017-03-07 |
| Find all providers in ROYAL OAK | ||||
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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.