Justin R Shannon, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

PA15715 Issued in CA

Practice address

2175 Rosaline Ave
Redding, CA 96001-2509

Phone

(530) 225-6000

Fax

(818) 587-2493

NPI assigned

Jul 3, 2006

Sex

Male

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 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

96.69 of 100Reported as group

Quality

90

Improvement activities

40

Cost

78.43

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment NPD
• Enloe Medical Center

  • Urgent Care Clinic/Center
  • Chico, CA
  • NPI 1396753281
  Medicare reassignment NPD
• Enloe Medical Center

  • Surgery Physician
  • Chico, CA
  • NPI 1477975613
  Medicare reassignment NPD
• Cep America - California

  • Emergency Medicine Physician
  • Redding, CA
  • NPI 1376604686
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Enloe Medical Center

  • Community/Retail Pharmacy
  • Chico, CA
  • NPI 1912949538
  NPD
• Vitas Health Services of California Inc

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Covina, CA
  • NPI 1780973024

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508284800000",
    "number": "1093745655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "STE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081844",
            "telephone_number": "510-851-7423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 ROSALINE AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012509",
            "telephone_number": "530-225-6000",
            "fax_number": "818-587-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "JUSTIN",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2017-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "PA15715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN559900",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00249929",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheri Shadwell
• Bruce Robert Shafer
• David Benjamin Shafer
• Lydia Shalberg
• Shannika Dao DDS Inc.
• Aishwarya Sharma, DO
• Sharon Louanne Hughes
• Eric William Sharrock, MCJ
• Shasta
• Shasta Anesthesia Consultants a Medical Group Inc

• Nurse Practitioner in Redding, CA
• Providers in Redding, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.