Individual provider Active NPI

Shannon L Hernandez, CNP

  • Family Nurse Practitioner
  • Carlsbad, NM
National Provider Identifier
1083120760
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP03456 Issued in NM
Practice address
711 W Church St
Carlsbad, NM 88220
Phone
(575) 725-5211
Fax
(575) 725-5212
NPI assigned
Dec 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP03456 NM Primary

Addresses

Primary practice location

711 W Church St
Carlsbad, NM 88220

Mailing address

711 W Church St
Carlsbad, NM 88220
Phone (575) 725-5211

Other practice location 1

1410 N 8th St Ste B
Carlsbad, NM 88220-3217
Phone (575) 941-2500

Other names 1

  • Shannon L Roper Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180201001035 NM Practitioner - Nurse Practitioner 9436418548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

711 W Church St
Carlsbad, NM 88220-5137
Phone (575) 725-5211

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP03456NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roper'S Health Oasis Family CurrentSince Mar 15, 2018 Accepting new patients
Sparkman Behavioral Health, P. C. Past Accepting new patients

Locations

110 S Halagueno St
Ste 8
Carlsbad, NM 88220
Phone (575) 725-5211

711 W Church St
Carlsbad, NM 88220
Phone (575) 725-5211

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1083120760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W CHURCH ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "88220",
            "telephone_number": "575-725-5211",
            "fax_number": "575-725-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W CHURCH ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "88220",
            "telephone_number": "575-725-5211",
            "fax_number": "575-725-5212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1410 N 8th St Ste B",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "NM",
            "postal_code": "882203217",
            "country_code": "US",
            "telephone_number": "575-941-2500",
            "fax_number": "575-941-2503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "SHANNON",
        "middle_name": "L",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-18",
        "last_updated": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP03456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "ROPER",
            "middle_name": "L",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carlsbad, NM

Sources for this page

Verify at the official NPI Registry.