Individual provider Active NPI

Connor Shannon, DC

  • Chiropractor
  • Friday Harbor, WA
National Provider Identifier
1457063505
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH61599467 Issued in WA
Practice address
545 Spring St
Friday Harbor, WA 98250-8057
Phone
(360) 378-5660
NPI assigned
Dec 20, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH61599467 WA Primary

Addresses

Primary practice location

545 Spring St
Friday Harbor, WA 98250-8057

Mailing address

545 Spring St
Friday Harbor, WA 98250-8057
Phone (360) 378-5660

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230721003362 OR Practitioner - Chiropractic 4082074067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2022
Medicare assignment
May accept Medicare assignment
Group practices
2Chirosmission Chiropractic Center LLCGroup PAC ID 2769624824, 6 clinicians

Practice addresses (Care Compare)

409 NE Greenwood Ave
Suite 120
Bend, OR 97701-4616
Phone (541) 728-0954

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH61599467WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Island Hearing Healthcare, LLC CurrentSince May 4, 2025 Accepting new patients
2Chirosmission Chiropractic Center LLC Chiropractor CurrentSince Dec 8, 2025 Accepting new patients

Locations

409 NE Greenwood Ave
Ste 120
Bend, OR 97701
Phone (541) 728-0954

545 Spring St
Friday Harbor, WA 98250
Phone (360) 378-2330

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1671494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1457063505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 SPRING ST",
            "city": "FRIDAY HARBOR",
            "state": "WA",
            "postal_code": "982508057",
            "telephone_number": "360-378-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 SPRING ST",
            "city": "FRIDAY HARBOR",
            "state": "WA",
            "postal_code": "982508057",
            "telephone_number": "360-378-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "CONNOR",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-20",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH61599467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Friday Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.