Active NPI
Shawn Fanning
- Emergency Registered Nurse
- Rapid City, SD
National Provider Identifier
1225652282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Registered Nurse
- License
- R029763
- Practice address
- 7675 Mount Rushmore Rd
Rapid City, SD 57702-8760 - Phone
- (307) 752-2862
- NPI assigned
- Jun 4, 2020
- Last updated
- Jun 4, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Registered Nurse | 163WE0003X | R029763 | SD | Primary |
Addresses
Primary practice location
7675 Mount Rushmore Rd
Rapid City, SD 57702-8760
Mailing address
7675 Mount Rushmore Rd
Rapid City, SD 57702-8760
Other practice location 1
Kayenta
Hwy 160 M.P. 394.3
Kayenta, AZ 86033
Phone (928) 697-4000
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R029763 | SD | MD | Emergency Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591228800000",
"number": "1225652282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7675 MOUNT RUSHMORE RD",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577028760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7675 MOUNT RUSHMORE RD",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577028760",
"telephone_number": "307-752-2862"
}
],
"practiceLocations": [
{
"address_1": "Kayenta",
"address_2": "Hwy 160 M.P. 394.3",
"address_purpose": "LOCATION",
"city": "Kayenta",
"state": "AZ",
"postal_code": "86033",
"country_code": "US",
"telephone_number": "928-697-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FANNING",
"first_name": "SHAWN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-04",
"last_updated": "2020-06-04",
"certification_date": "2020-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "163WE0003X",
"taxonomy_group": "",
"desc": "Registered Nurse, Emergency",
"state": "SD",
"license": "R029763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rapid City, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.