Shawnee Seychelle Gonzalez

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT8947 Issued in TX

Practice address

4901 E University Blvd
Odessa, TX 79762-8122

Phone

(432) 552-3685

NPI assigned

Nov 30, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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": "1669766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1356051429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 FALCONS NEST CIR",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797629621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 E UNIVERSITY BLVD",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797628122",
            "telephone_number": "432-552-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "SHAWNEE",
        "middle_name": "SEYCHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-30",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT873",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NM",
            "license": "AT873",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT8947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://utpb.sharepoint.com/sites/Athletics/PrivateDocuments/Sports%20Medicine/ATR%20Forms/SOAP%20Note%20Form.pdf?CT=1669827486796&OR=ItemsView",
            "affiliation": "N",
            "address_1": "4901 E University Blvd",
            "city": "Odessa",
            "state": "TX",
            "country_code": "US",
            "postal_code": "797628122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Yarines Gonzalez Mendoza, NP-C
• Laura Mariana Gonzalez Reyes, MD
• Alfonso Ivan Gonzalez, M.D.
• Diana D Gonzalez, PTA
• Refugio Gonzalez III, DDS
• Stephanie Gonzalez
• Carina Rose Goodart
• Ashley Goodgame
• Jann Ronald Gordils Torres
• Isis Gordon

• Athletic Trainer in Odessa, TX
• Providers in Odessa, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.