Shannon Connolly, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A121107 Issued in CA

Practice address

14372 Beach Blvd
Westminster, CA 92683-4578

Phone

(714) 922-4100

NPI assigned

Apr 14, 2010

Last updated

Dec 18, 2024By the provider in NPPES

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 20, 2026 through Jan 20, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Connolly, Poulin, & Tressan, a Medical Corporatiom

  • Family Medicine Physician
  • Orange, CA
  • NPI 1538004577
  NPD Authorized official
• Planned Parenthood/Orange and San Bernardino Counties, Inc.

  dba Melody Health

  • Clinic/Center
  • Santa Ana, CA
  • NPI 1063481562
  NPD (past)
• Planned Parenthood/Orange and San Bernardino Counties, Inc.

  dba Melody Health

  • Clinic/Center
  • Mission Viejo, CA
  • NPI 1235108713
  NPD (past)
• Planned Parenthood/Orange and San Bernardino Counties, Inc.

  dba Melody Health

  • Clinical Medical Laboratory
  • Anaheim, CA
  • NPI 1285754598
  NPD (past)
• Planned Parenthood/Orange and San Bernardino Counties, Inc.

  dba Melody Health

  • Clinic/Center
  • Westminster, CA
  • NPI 1316916836
  NPD (past)
• Planned Parenthood/Orange and San Bernardino Counties, Inc.

  dba Melody Health

  • Clinic/Center
  • Costa Mesa, CA
  • NPI 1609845171
  NPD (past)

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1457677569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 COLORADO AVE",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904043414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14372 BEACH BLVD",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926834578",
            "telephone_number": "714-922-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-14",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A121107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Care Providers, Inc.
• Community Heritage Corporation (Family Heritage Home Health)
• Compassionate Health Hospice Inc
• Comprehensive Care Physical Therapy Services, Inc.
• Jenny Cong
• Consumerhealth, Inc. (Newport Dental Westminster Ortho)
• Consumerhealth, Inc. (Newport Dental - Westminster)
• Consumerhealth, Inc. (Newport Dental - Westminister)
• Monique Coomes
• Thomas J Cooper Jr., MD

• Family Medicine Physician in Westminster, CA
• Providers in Westminster, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.