Individual provider Active NPI

Shannon Lynette Ermshar

  • Peer Specialist
  • Riverside, CA
National Provider Identifier
1306458823
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
4440 University Ave
Riverside, CA 92501-3199
Phone
(951) 465-2135
NPI assigned
Aug 17, 2020
Last updated
May 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X CA Primary

Addresses

Primary practice location

4440 University Ave
Riverside, CA 92501-3199

Mailing address

5870 Arlington Ave
Riverside, CA 92504-2037
Phone (951) 509-2499

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

NPI Registry JSON

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1306458823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5870 ARLINGTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925042037",
            "telephone_number": "951-509-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 UNIVERSITY AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013199",
            "telephone_number": "951-465-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERMSHAR",
        "first_name": "SHANNON",
        "middle_name": "LYNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.