Individual provider Active NPI

Shannon Lynne Porter, ARNP

  • Family Nurse Practitioner
  • Sun City West, AZ
National Provider Identifier
1356894422
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
279033 Issued in AZ
Practice address
14416 W Meeker Blvd # 200
Sun City West, AZ 85375-5284
Phone
(623) 876-3800
Fax
(623) 285-2713
NPI assigned
Jul 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60672144 WA
Nurse Practitioner 363L00000X AP60672144 WA
Family Nurse Practitioner 363LF0000X 279033 AZ Primary

Addresses

Primary practice location

14416 W Meeker Blvd # 200
Sun City West, AZ 85375-5284

Mailing address

14416 W Meeker Blvd # 200
Sun City West, AZ 85375-5284
Phone (623) 867-3800

Other identifiers 1

IdentifierTypeStateIssuer
2065487MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20230523000680 AZ Practitioner - Nurse Practitioner 7012205586 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Washington School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4055 Valley View LN
Suite 400
Dallas, TX 75244-4910

525 W Brown Rd
Mesa, AZ 85201-3202

Hospital & facility affiliations

  • Banner del E. Webb Medical Center Hospital, Sun City West, AZ, CCN 030093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60672144WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Primary Care Physicians Arizona LLC CurrentSince Jul 8, 2025 Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Jul 8, 2025 Accepting new patients
Signify Health, LLC Nurse Practitioner CurrentSince May 15, 2023 Accepting new patients
Banner Primary Care Physicians Arizona LLC Current Accepting new patients
Banner Primary Care Physicians Arizona LLC Past Accepting new patients

Locations

2705 S Alma School Rd
Chandler, AZ 85286
Phone (480) 820-7246

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

14416 W Meeker Blvd
#200
Sun City West, AZ 85375
Phone (623) 583-5260

14416 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 583-5083

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1356894422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14416 W MEEKER BLVD # 200",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755284",
            "telephone_number": "623-867-3800",
            "fax_number": "623-285-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14416 W MEEKER BLVD # 200",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755284",
            "telephone_number": "623-876-3800",
            "fax_number": "623-285-2713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "SHANNON",
        "middle_name": "LYNNE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60672144",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60672144",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "279033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2065487",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

Verify at the official NPI Registry.