National Provider Identifier Database

SHANNON M BURGESS OD
Medical Specialty

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).


Contact Information

SHANNON M. BURGESS, OD
1260 VALLEY FORGE RD
SUITE 108
PHOENIXVILLE, PA19460-2691
Phone: 610-917-0700
Fax: 610-917-0708
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for SHANNON M. BURGESS, OD

NPI Number 1275835829
Legal business name
LBN
SHANNON M. BURGESS, OD
Authorized official SHANNON BURGESS - (OPTOMETRIST)
Entity Organization
Organization subpart No
Enumeration date 12/01/2010
Last updated 08/25/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • PA License #: OEG000127
  • Other: 001321149 BLUE SHIELD
  • Other: 50004981 CAPITAL BLUE CROSS
  • Other: 2013716000 KEYSTONE HEALTH PLAN

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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