Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Shannon Marie Sullivan, MD

Individual provider Family Medicine Physician · NPI 1972998680

Dr. Shannon Marie Sullivan, MD is a Family Practice in Menasha, Wisconsin. Graduated from Loyola University of Chicago, Stritch School of Medicine in 2015, 11 years ago. Practices with Thedacare, Incorporated, a 654-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
11
Trained at
Loyola University of Chicago, Stritch School of Medicine
Licensed in
WI
In the registry since
2015
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2005 Midway Rd
Menasha, WI 54952
Phone: (920) 832-8500
Fax: (920) 993-2919
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1121 E North Ave, Milwaukee, WI 53212-3515 — (414) 267-6502

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 66251 (WI)

Record details

NPI number1972998680
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 31, 2015
Last updated in NPPESSeptember 13, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolLOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Graduated 2015 (11 years in practice)
Group practice Thedacare, Incorporated — 654 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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