Shannon V Chavez, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G59169 Issued in CA

Practice address

200 W Arbor Dr
San Diego, CA 92103-9001

Phone

(619) 497-6665

NPI assigned

Jul 11, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: schavez308140@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Open Door Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Crescent City, CA
  • NPI 1497840656
  Medicare reassignment
• Open Door Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Eureka, CA
  • NPI 1336173020
  NPD
• Open Door Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Eureka, CA
  • NPI 1831713452
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003841818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR",
            "address_2": "MAIL CODE 0603-G",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920935004",
            "telephone_number": "619-497-6665",
            "fax_number": "619-497-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039001",
            "telephone_number": "619-497-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "SHANNON",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G59169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G591690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Nicole Chavez
• Nebai Chavez
• Pricilla Chavez
• Ruben Chavez Jr.
• Samantha Chavez
• Silverio T. Chavez, MD
• Sinoe Alfredo Chavez
• Stephanie Chavez, RD
• Veronika Chavez
• Walter Don Martinez Chavez

• Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.