Shannon Lesley Lange, CPNP-PC, CNS

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1013771 Issued in TX

Practice address

Brooke Army Medical Center
3551 Roger Brooke Drive
San Antonio, TX 78234-4504

Phone

(210) 916-3160

NPI assigned

Oct 2, 2018

Sex

Female

Sole proprietor

No

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

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1225513591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19TH MEDICAL GROUP 1090 ARNOLD DRIVE",
            "city": "LITTLE ROCK AFB",
            "state": "AR",
            "postal_code": "720994933",
            "telephone_number": "501-987-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BROOKE ARMY MEDICAL CENTER",
            "address_2": "3551 ROGER BROOKE DRIVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "SHANNON",
        "middle_name": "LESLEY",
        "name_prefix": "Ms.",
        "credential": "CPNP-PC, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "NP95009977",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1013771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Julian Lange, MA, LPC-INTERN
• Isaiah Lange, DO
• Johnny Ray Lange, LVN
• Jory D Lange, M.D.
• Linda D. Lange, LVN
• Dawn T Langeland, MD
• Anne-Marie Langevin, MD
• Maria Margarita Langford, R.D., L.D.
• Josephine Langham, LPC
• Robert P Langlais, DDS MS

• Pediatric Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.