Shannon Conrad, L.AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC140952 Issued in OR

Practice address

1910 SE 11TH Ave Ste 200
Portland, OR 97214-4707

Phone

(503) 208-6327

Fax

(503) 455-4402

NPI assigned

Oct 5, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Spirit Point Medicine Inc

  • Acupuncturist
  • Portland, OR
  • NPI 1689034316
  NPD (past) Authorized official

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1174858484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5532 SE KNIGHT STREET",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97206",
            "telephone_number": "503-453-3577",
            "fax_number": "503-455-4402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 SE 11TH AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144707",
            "telephone_number": "503-208-6327",
            "fax_number": "503-455-4402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1516 SE 43rd Suite 2",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97215",
            "country_code": "US",
            "telephone_number": "503-208-6327",
            "fax_number": "503-455-4402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "SHANNON",
        "name_prefix": "Mrs.",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-05",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "140952",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC140952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire McCord Conrad, MD
• Marlen Shirley Conrad, LCSW
• Maryann Conrad, MD
• Melinda Lee Herbaugh Conrad, MA PCA
• Nicole Marie Conrad, M.D.
• Suki Katheryn Conrad, MD
• Carol Ray Conrades, PT
• Christopher Conrady, CPNP
• Jesus Ernesto Conrique Garcia
• Kimberly A Conrow, MA, LPC, CADC-1

• Acupuncturist in Portland, OR
• Providers in Portland, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; 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.