SHANNON MARIE SCANLON (FNP) – Family Nurse Practitioner, NPI 1104545292

SHANNON MARIE SCANLON (FNP) is a healthcare provider. based in Grand ledge, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 2022008174 (MI). The NPI Number for SHANNON MARIE SCANLON (FNP) is 1104545292

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
SHANNON MARIE SCANLON (FNP)
NPI
1104545292
Phone
(254) 258-2584
Address
701 PLEASANT ST
Enumeration Date
23 August 2022
Last Update Date
23 August 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2696601670
Graduation Year
2022 (4 years ago)
PAC ID
4284006008
Group Practice PAC ID
2668467838
Professional Enrollment ID
I20230203001896
Address ID
MI490148562BA7070XNXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

8,105 NURSE PRACTITIONER in MI

Provider Addresses for SHANNON MARIE SCANLON (FNP)

  • 701 PLEASANT ST

    GRAND LEDGE, MI 488371344

    Phone: (254) 258-2584

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $46.

Total Amount is formed as General ($46) + Research ($0) + Ownership ($0) = $46.

Last reported payment date: 2024-09-04 • Largest payer in this snapshot: Biofrontera Inc. ($27).

Total Amount

$46

General + Research + Ownership

Payments

2

Total payment records

General Amount

$46

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-04

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Biofrontera Inc.$27
PFIZER INC.$19
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-02-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230203001896INurse PractitionerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes737235$0
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes379119$0
99307Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes7463$0
99310Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes7337$0
View full utilization report →

Insurance plans in this area (ZIP 48837)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2668467838View full group profile
NameSpecialtyState
Physician AssistantMI
-MI
D E R M A T O L O G YMI
Physician AssistantMI
Physician AssistantMI
Physician AssistantOH
Physician AssistantMI
Physician AssistantMI
Physician AssistantMI
Micrographic Dermatologic Surgery (Mds), DermatologyMI

Reviews

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Frequently asked questions

Can I use this page to confirm SHANNON MARIE SCANLON (FNP)'s NPI?
Yes. SHANNON MARIE SCANLON (FNP) is listed with NPI 1104545292 in the public NPI dataset.
Does the file indicate SHANNON MARIE SCANLON (FNP) is practicing under active NPI?
Directory data currently reports SHANNON MARIE SCANLON (FNP) as active.
What taxonomy line describes SHANNON MARIE SCANLON (FNP)?
For research purposes, treat SHANNON MARIE SCANLON (FNP) as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for SHANNON MARIE SCANLON (FNP)?
SHANNON MARIE SCANLON (FNP)'s geographic hint is Grand Ledge, Michigan in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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