Individual provider Active NPI

Donna Marie Shannon, R.N.01

  • Registered Nurse
  • Brentwood, NY
National Provider Identifier
1609145440
Registry record updated Dec 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN227009-1 Issued in NY
Practice address
186 Claywood Dr
Brentwood, NY 11717-6205
Phone
(631) 273-3015
NPI assigned
Dec 23, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN227009-1 NY Primary

Addresses

Primary practice location

186 Claywood Dr
Brentwood, NY 11717-6205

Mailing address

186 Claywood Dr
Brentwood, NY 11717-6205
Phone (631) 273-3015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN227009-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1324598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324598400000",
    "number": "1609145440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 CLAYWOOD DR",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117176205",
            "telephone_number": "631-273-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 CLAYWOOD DR",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117176205",
            "telephone_number": "631-273-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "DONNA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "R.N.01",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-23",
        "last_updated": "2011-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "RN227009-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; 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.