Shannon King, ADN

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

R52018 Issued in NM

Practice address

8200 Guadalupe TRL NW
Los Ranchos, NM 87114-1121

Phone

(505) 898-3666

NPI assigned

Jan 22, 2013

Last updated

Sep 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1358812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1043558331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 TARGET LN NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871203065",
            "telephone_number": "505-550-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 GUADALUPE TRL NW",
            "city": "LOS RANCHOS",
            "state": "NM",
            "postal_code": "871141121",
            "telephone_number": "505-898-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "SHANNON",
        "name_prefix": "Mrs.",
        "credential": "ADN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-22",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NM",
            "license": "R52018",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "R52018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jacob Kualapai, RDH, CDHC
• Charlotte Latham, PTA
• Virginia Marie Lawlor, B.A. C.P.R.P.

• Addiction (Substance Use Disorder) Registered Nurse in Los Ranchos, NM
• Providers in Los Ranchos, NM by specialty
• Addiction (Substance Use Disorder) Registered Nurse in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.