Individual provider Active NPI

Shannon Colette Christopher, NP

  • Family Nurse Practitioner
  • Broomfield, CO
National Provider Identifier
1447542642
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP 990371 Issued in CO
Practice address
433 Summit Blvd
Unit 201
Broomfield, CO 80021-8298
Phone
(303) 673-9090
NPI assigned
May 5, 2011
Last updated
Apr 18, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP 990371 CO Primary

Addresses

Primary practice location

433 Summit Blvd
Unit 201
Broomfield, CO 80021-8298

Mailing address

433 Summit Blvd
Unit 201
Broomfield, CO 80021-8298
Phone (303) 673-9090

Other identifiers 1

IdentifierTypeStateIssuer
9000144489MedicaidCO

Other names 1

  • Shannon Walker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20121009000346 CO Practitioner - Nurse Practitioner 3173772019 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP 990371COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Associates PC CurrentSince Feb 22, 2017 Accepting new patients
Mountain View Medical Group, PC Past Accepting new patients
Mountain View Medical Group, PC Past Accepting new patients

Locations

433 Summit Blvd
Unit 201
Broomfield, CO 80021
Phone (303) 673-9090

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1928/brand/1/csg/62/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/GBHGDD
  • Direct secure messaging: shannon.christopher.p1@direct.cemc.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1447542642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 SUMMIT BLVD",
            "address_2": "UNIT 201",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800218298",
            "telephone_number": "303-673-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 SUMMIT BLVD",
            "address_2": "UNIT 201",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800218298",
            "telephone_number": "303-673-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOPHER",
        "first_name": "SHANNON",
        "middle_name": "COLETTE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-05",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "NP 990371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000144489",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "WALKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.