Individual provider Active NPI

Shannalee Senior, APRN, AGNP-C

  • Adult Health Nurse Practitioner
  • Tempe, AZ
National Provider Identifier
1073141529
Registry record updated Jan 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
243295 Issued in AZ
Practice address
5025 S Ash Ave Ste a
Tempe, AZ 85282-6839
Phone
(623) 246-5700
NPI assigned
Mar 31, 2020
Last updated
Jan 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 243295 AZ Primary

Addresses

Primary practice location

5025 S Ash Ave Ste a
Tempe, AZ 85282-6839

Mailing address

5025 S Ash Ave Ste a
Tempe, AZ 85282-6839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NY, FL, MD, DC5 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20210922000764 AZ Practitioner - Nurse Practitioner 8527465368 Reassigns benefits to 1 organization
I20230302001932 NY Practitioner - Nurse Practitioner 8527465368
I20241226003013 FL Practitioner - Nurse Practitioner 8527465368 Reassigns benefits to 1 organization
I20250128004685 MD Practitioner - Nurse Practitioner 8527465368 Reassigns benefits to 1 organization
I20250129002261 DC Practitioner - Nurse Practitioner 8527465368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Physical Therapy and Rehab LLCGroup PAC ID 4284902339, 87 clinicians

Practice addresses (Care Compare)

2585 Miracle Mile
Bullhead City, AZ 86442-7522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
243295AZMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Community Healthcare Center CurrentSince Sep 1, 2021 Accepting new patients
Pasadena Center for Asthma & Lung Disorders LLC CurrentSince Jan 1, 2025 Accepting new patients
Consultants in Internal Medicine, P.C. CurrentSince Dec 20, 2021 Accepting new patients
Capital Healthcare PC CurrentSince Jan 1, 2025 Accepting new patients
Tri-State Community Healthcare Center CurrentSince Sep 1, 2021 Accepting new patients
Rosewood Ranch, LP PastSince Jan 1, 2021 Accepting new patients
Rosewood Ranch, LP PastSince Jan 1, 2021 Accepting new patients

Locations

5651 W Talavi Blvd
Ste 170
Glendale, AZ 85306
Phone (602) 843-1313

8700 S Highway 95
Mohave Valley, AZ 86440
Phone (928) 768-7113

4141 Verdugo Rd
Los Angeles, CA 90065
Phone (818) 760-5144

1615 Pasadena Ave S
Ste 200
South Pasadena, FL 33707
Phone (727) 341-0551

5454 Central Ave
Ste A
St Petersburg, FL 33707
Phone (727) 347-5242

8205 Snowden River Pkwy
Columbia, MD 21045
Phone (410) 290-9990

6020 Richmond Hwy
Ste 102
Alexandria, VA 22303
Phone (267) 978-1993

Interoperability endpoints

  • Direct secure messaging: shannalee.senior.1@15482.direct.athenahealth.com

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736640000000",
    "number": "1073141529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5025 S ASH AVE STE A",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852826839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5025 S ASH AVE STE A",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852826839",
            "telephone_number": "623-246-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENIOR",
        "first_name": "SHANNALEE",
        "credential": "APRN, AGNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2025-01-12",
        "certification_date": "2025-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "243295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.