Individual provider Active NPI

Shannon Dawn Vassar, RN

  • Registered Nurse
  • Columbus, IN
National Provider Identifier
1104396035
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
28125081A Issued in IN
Practice address
700 Washington St Ste 205
Columbus, IN 47201-6295
Phone
(812) 378-0615
Fax
(812) 378-7989
NPI assigned
Dec 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28125081A IN Primary

Addresses

Primary practice location

700 Washington St Ste 205
Columbus, IN 47201-6295

Mailing address

700 Washington St Ste 205
Columbus, IN 47201-6295
Phone (812) 378-0615

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
28125081AINMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1104396035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 WASHINGTON ST STE 205",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472016295",
            "telephone_number": "812-378-0615",
            "fax_number": "812-378-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WASHINGTON ST STE 205",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472016295",
            "telephone_number": "812-378-0615",
            "fax_number": "812-378-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASSAR",
        "first_name": "SHANNON",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-04",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28125081A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.