Susan Veronica Shannon, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

9224 Issued in CA

Practice address

2653 Elm Ave
Suite 200
Long Beach, CA 90806-1652

Phone

(562) 728-5000

Fax

(562) 933-1815

NPI assigned

Dec 7, 2016

Last updated

Dec 7, 2016By 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

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sshannonnp2224@direct.memorialcare.org

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.

• Long Beach Memorial Medical

  dba Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Long Beach, CA
  • NPI 1891890158
  NPD (past)

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1588108781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2653 ELM AVE",
            "address_2": "SUITE 200",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061652",
            "telephone_number": "562-728-5000",
            "fax_number": "562-933-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 ELM AVE",
            "address_2": "SUITE 200",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061652",
            "telephone_number": "562-728-5000",
            "fax_number": "562-933-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "SUSAN",
        "middle_name": "VERONICA",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-07",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "9224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Ellen Shanks, PH.D.
• Amy Lynne Shannon, LVN
• Chibuzor P Shannon
• Crystal Jeannine Shannon
• Martell Da'Shawn Shannon
• Siqi Shao, NP
• Mehrdad Kheyrollahi Sharif, M.D.
• Jagadev Prakash Sharma, LCSW
• Sharon Bruce Chiropractic PC
• Robin E Sharp Johnsen

• Nurse Practitioner in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.