Shannon Marie Chan, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP141616 Issued in TX

Practice address

5521 Ventana del Sol Dr
El Paso, TX 79912-3453

Phone

(917) 318-9518

NPI assigned

Feb 12, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Shannon Marie Chan Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1215520085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5521 VENTANA DEL SOL DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799123453",
            "telephone_number": "917-318-9518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5521 VENTANA DEL SOL DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799123453",
            "telephone_number": "917-318-9518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-12",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP141616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "CHAN",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "FNP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jeffrey Chambers, MD
• Chamizal Emergency Physicians PLLC
• Anne Catherine Chan, MD
• Kempes Brian Chan, MD
• Maria I Chan
• Nitin Chanana, M.D
• Jessica Nicole Chandler, D.O..
• Karen Batchelder Chandler, DMD
• Nikkolina Chandler
• Aymara Yadira Chang Lopez, M.D.

• Family Nurse Practitioner in El Paso, TX
• Providers in El Paso, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; 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.