Shannon Brooke Daniels, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

321242 Issued in AZ

Practice address

6750 E Broadway Rd
Mesa, AZ 85206-1700

Phone

(480) 756-6789

NPI assigned

Mar 17, 2025

Last updated

Mar 17, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Advanced Pain Modalities, PLC

  • Pain Medicine (Anesthesiology) Physician
  • Chandler, AZ
  • NPI 1760639058
  NPD (past)

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

{
    "created_epoch": "1742169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1588464697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N BARKLEY",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852038933",
            "telephone_number": "602-930-5648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 E BROADWAY RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061700",
            "telephone_number": "480-756-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "SHANNON",
        "middle_name": "BROOKE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "321242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Hamblin Dangerfield, LCSW
• Daniel J Kinkead PC (Kinkead Chiropractic)
• Amelia E Daniels, MT-BC
• Leslie L Daniels, BSN, RN, NCSN
• Robin Daniels, CNM
• Elizabeth Danielson, PH.D.
• Justine Morgan Danielson
• Patricia Danna-Premo, MS, LAC, NCC
• Dantal Dental Corporation
• Anh Dao, M.D.

• Gerontology Nurse Practitioner in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Gerontology Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.