Active NPI
Shannon Marie Nansel, PEER SUPPORT SPECIAL
- Peer Specialist
- Kellogg, ID
National Provider Identifier
1619453370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 740 McKinley Ave
Kellogg, ID 83837-2693 - Phone
- (208) 512-1574
- NPI assigned
- Jul 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
740 McKinley Ave
Kellogg, ID 83837-2693
Mailing address
PO Box 1387
Hayden, ID 83835-1387
Phone (208) 415-0299
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Westwind Wellness Clinic PLLC | Peer Specialist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Coeur D Alene, ID
- NPI 1427822485
Peer Specialist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647820800000",
"number": "1619453370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1387",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838351387",
"telephone_number": "208-415-0299",
"fax_number": "208-625-2070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "740 MCKINLEY AVE",
"city": "KELLOGG",
"state": "ID",
"postal_code": "838372693",
"telephone_number": "208-512-1574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NANSEL",
"first_name": "SHANNON",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "PEER SUPPORT SPECIAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-16",
"last_updated": "2022-03-21",
"certification_date": "2022-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kellogg, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.