Active NPI
Brienne Shannon
- Other Technician
- Longwood, FL
National Provider Identifier
1093268054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- Practice address
- 151 W Church Ave
Longwood, FL 32750-4105 - Phone
- (407) 205-7794
- NPI assigned
- Jul 26, 2016
- Last updated
- May 23, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | NU | Primary |
Addresses
Primary practice location
151 W Church Ave
Longwood, FL 32750-4105
Mailing address
414 E 9TH St
Apopka, FL 32703-6406
Other practice location 1
4575 SE Dixie Hwy
Stuart, FL 34997-6826
Phone (855) 832-6727
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558569600000",
"number": "1093268054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 E 9TH ST",
"city": "APOPKA",
"state": "FL",
"postal_code": "327036406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 W CHURCH AVE",
"city": "LONGWOOD",
"state": "FL",
"postal_code": "327504105",
"telephone_number": "407-205-7794"
}
],
"practiceLocations": [
{
"address_1": "4575 SE Dixie Hwy",
"address_purpose": "LOCATION",
"city": "Stuart",
"state": "FL",
"postal_code": "349976826",
"country_code": "US",
"telephone_number": "855-832-6727",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHANNON",
"first_name": "BRIENNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-26",
"last_updated": "2019-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longwood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.