Individual provider Active NPI

Shannon Kay Daniel, NP

  • Nurse Practitioner
  • Roswell, NM
National Provider Identifier
1245709179
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
24391 Issued in TN
Practice address
400 N Pennsylvania Ave Ste 101
Roswell, NM 88201-4758
Phone
(575) 623-9101
NPI assigned
Nov 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 24391 TN Primary

Addresses

Primary practice location

400 N Pennsylvania Ave Ste 101
Roswell, NM 88201-4758

Mailing address

400 N Pennsylvania Ave Ste 101
Roswell, NM 88201-4758
Phone (575) 623-9101

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
24391TNMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spine and Orthopedic Center of New Mexico PC PastSince Jul 8, 2013 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7206/brand/1/csg/1/fhir/r4
  • Direct secure messaging: sdanie44@yourcarecommunity.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1245709179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PENNSYLVANIA AVE STE 101",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882014758",
            "telephone_number": "575-623-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PENNSYLVANIA AVE STE 101",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882014758",
            "telephone_number": "575-623-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "SHANNON",
        "middle_name": "KAY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-20",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "24391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.