Individual provider Active NPI

Shannon Chakedis

  • Nurse Practitioner
  • Walnut Creek, CA
National Provider Identifier
1134527690
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95010200 Issued in CA
Practice address
177 La Casa Via Ste 390
Walnut Creek, CA 94598-6101
Phone
(925) 692-5610
NPI assigned
Dec 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X COA.18791-NP OH
Registered Nurse 163W00000X 766408 CA
Nurse Practitioner 363L00000X NP95010200 CA Primary

Addresses

Primary practice location

177 La Casa Via Ste 390
Walnut Creek, CA 94598-6101

Mailing address

1450 Treat Blvd # 300
Walnut Creek, CA 94597-2168
Phone (925) 952-2828

Other names 1

  • Shannon Brouman Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230601001773 CA Practitioner - Nurse Practitioner 1759677966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
John Muir Physician NetworkGroup PAC ID 6608789813, 488 clinicians

Practice addresses (Care Compare)

400 Taylor Blvd
Suite 202
Pleasant Hill, CA 94523-2163
Phone (925) 677-5041

Hospital & facility affiliations

  • John Muir Medical Center - Concord Campus Hospital, Concord, CA, CCN 050496
  • John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180

Merit-based Incentive Payment System (MIPS)

Final score
90.32 of 100Reported as group
Quality
89.54
Promoting interoperability
100
Improvement activities
40
Cost
74.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
766408CAMDRegistered Nurse
NP95010200CAMDNurse Practitioner
COA.18791-NPOHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Physician Network CurrentSince May 1, 2023 Accepting new patients

Locations

2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112

400 Taylor Blvd
Ste 202
Pleasant Hill, CA 94523
Phone (925) 932-4567

380 Civic Dr
Ste 100
Pleasant Hill, CA 94523
Phone (925) 284-3840

1450 Treat Blvd
#300
Walnut Creek, CA 94597
Phone (925) 952-2828

177 La Casa Via
Ste 390
Walnut Creek, CA 94598
Phone (925) 692-5610

Interoperability endpoints

  • Direct secure messaging: schakedis146193@ehr.johnmuirhealth.com

Organizations & group practices 1

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 2

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": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1134527690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 TREAT BLVD # 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945972168",
            "telephone_number": "925-952-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 LA CASA VIA STE 390",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945986101",
            "telephone_number": "925-692-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAKEDIS",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-16",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA.18791-NP",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "766408",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95010200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "BROUMAN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.