Shannon Vanderpool

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

161835 Issued in TX

Practice address

1907 Dartmouth St
College Station, TX 77840-7042

Phone

(797) 220-0057

NPI assigned

Sep 3, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1447808456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 DARTMOUTH ST",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778407042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 DARTMOUTH ST",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778407042",
            "telephone_number": "797-220-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERPOOL",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "161835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kali Utsey, L.A.T.
• Justin Severn Utz, DC
• Jennifer Uzoma
• Korie Turner Vakey, M.D.
• Kendall Van de Walle, PA
• Chelsea Michelle Vandiver, DPT
• Jennifer Variste, M.D.
• Dora Rosali Vasquez, CRNA
• Matthew R Vassaur, MD
• Davida Danielle Vaughn, MS., ED.S., LPC

• Licensed Vocational Nurse in College Station, TX
• Providers in College Station, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.