DR. SHANNON R GINNAN (M.D.) – General Practice Physician, NPI 1487839080

DR. SHANNON R GINNAN (M.D.) is a healthcare provider. based in Vienna, Virginia. specializing in General Practice Physician. They hold the professional credentials M.D.. They hold a License No. 0101231928 (VA). The NPI Number for DR. SHANNON R GINNAN (M.D.) is 1487839080

Main info

Male
26 Years Of Experience
Accepts Medicare Assignment
Name
DR. SHANNON R GINNAN (M.D.)
NPI
1487839080
Phone
(703) 677-3200
Address
1934 OLD GALLOWS RD
Enumeration Date
2 January 2008
Last Update Date
27 September 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2000 (26 years ago)
PAC ID
6800039702
Professional Enrollment ID
I20130824000189
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

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Provider Addresses for DR. SHANNON R GINNAN (M.D.)

  • Bertucci's, 1934, Old Gallows Road, Vienna, Fairfax (city), Virginia, 22027, United States

    SUITE 500

    VIENNA, VA 221824042

    Phone: (703) 677-3200

    Fax: (703) 677-3201

    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 1 Open Payments records for all available years, with a total value of $125.

Total Amount is formed as General ($125) + Research ($0) + Ownership ($0) = $125.

Last reported payment date: 2023-01-31 • Largest payer in this snapshot: Johnson & Johnson Health Care Systems Inc. ($125).

Total Amount

$125

General + Research + Ownership

Payments

1

Total payment records

General Amount

$125

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-31

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2013-08-24

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
I20130824000189IGeneral PracticeDCTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 22182)

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Reviews

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Frequently asked questions

Can I use this page to confirm DR. SHANNON R GINNAN (M.D.)'s NPI?
Yes. DR. SHANNON R GINNAN (M.D.) is listed with NPI 1487839080 in the public NPI dataset.
Is DR. SHANNON R GINNAN (M.D.) listed as active for patients and plans?
The listing shows DR. SHANNON R GINNAN (M.D.) as active in the NPI system.
What is DR. SHANNON R GINNAN (M.D.)'s specialty?
The listing groups DR. SHANNON R GINNAN (M.D.) with General Practice Physician. Clinical services aligned with this taxonomy classification.
What address line appears for DR. SHANNON R GINNAN (M.D.)?
DR. SHANNON R GINNAN (M.D.)'s geographic hint is Vienna, Virginia in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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