Individual provider Active NPI

Sonia Simeoni-Shannon

  • Family Nurse Practitioner
  • Santa Fe, NM
National Provider Identifier
1104459908
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
60073 Issued in NM
Practice address
34 Cuesta Rd
Santa Fe, NM 87508-8780
Phone
(607) 215-2807
NPI assigned
Feb 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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 60073 NM Primary

Addresses

Primary practice location

34 Cuesta Rd
Santa Fe, NM 87508-8780

Mailing address

34 Cuesta Rd
Santa Fe, NM 87508-8780
Phone (607) 215-2807

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
I20200610001593 NM Practitioner - Nurse Practitioner 8527489947 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
St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

455 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 913-3975

Hospital & facility affiliations

  • Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60073NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital General Acute Care Hospital Current Accepting new patients
St Vincent Hospital CurrentSince Jun 8, 2020 Accepting new patients
St. Vincent Hospital CurrentSince Jun 8, 2020 Accepting new patients

Locations

1631 Hospital Dr
Ste 240
Santa Fe, NM 87505
Phone (505) 913-3975

5501 Herrera Dr
#B
Santa Fe, NM 87507
Phone (505) 913-4180

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

5501 Herrera Dr
Santa Fe, NM 87507
Phone (505) 913-3233

455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361

2990 Rodeo Park Dr E
Santa Fe, NM 87505
Phone (505) 428-5400

Interoperability endpoints

  • Direct secure messaging: ssimeonishannon164147@christushealth.direct-ci.net

Organizations & group practices 4

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 1

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": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1104459908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 CUESTA RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875088780",
            "telephone_number": "607-215-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 CUESTA RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875088780",
            "telephone_number": "607-215-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMEONI-SHANNON",
        "first_name": "SONIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "60073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.