Individual provider Active NPI

Shianne Stilson, CPSS

  • Peer Specialist
  • Tooele, UT
National Provider Identifier
1174158257
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
134 W 1180 N Ste 5
Tooele, UT 84074-1483
Phone
(435) 248-0333
Fax
(435) 248-0334
NPI assigned
Mar 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X UT Primary

Addresses

Primary practice location

134 W 1180 N Ste 5
Tooele, UT 84074-1483

Mailing address

134 W 1180 N Ste 5
Tooele, UT 84074-1483
Phone (435) 248-0333

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": "1583712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1174158257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 W 1180 N STE 5",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840741483",
            "telephone_number": "435-248-0333",
            "fax_number": "435-248-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 W 1180 N STE 5",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840741483",
            "telephone_number": "435-248-0333",
            "fax_number": "435-248-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILSON",
        "first_name": "SHIANNE",
        "credential": "CPSS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-09",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tooele, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.