Shannon Dockham, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95007952 Issued in CA

Practice address

554 Blossom Hill Rd
San Jose, CA 95123-3212

Phone

(408) 281-2772

NPI assigned

May 13, 2019

Last updated

Jun 22, 2019By 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

Credentials

Nurse Practitioner

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.

• California Emergency Physicians

  • Family Medicine Physician
  • Campbell, CA
  • NPI 1750302600
  Medicare reassignment NPD
• Contra Costa County

  dba West County Adult Mental Health Services

  • Adult Mental Health Clinic/Center
  • San Pablo, CA
  • NPI 1376620336
  Medicare reassignment
• California Emergency Physicians

  • Physical Therapist
  • San Jose, CA
  • NPI 1801084348
  NPD
• California Emergency Physicians

  • Family Medicine Physician
  • San Jose, CA
  • NPI 1922020940
  NPD

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561161600000",
    "number": "1679139943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "STE 400",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 BLOSSOM HILL RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951233212",
            "telephone_number": "408-281-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCKHAM",
        "first_name": "SHANNON",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2019-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95007952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tuan Manh Doan, PHARMACIST
• Tuyet-Linh Thi Doan, MD
• Rajesh Dobbay, DC
• Valery Dobrushin
• Joanne F. Dobrzynski, MFT
• Jenavieve Doctolero
• Doctususa Inc
• Jill Marie Dodge, RRT
• Catherine Doerr
• Ashley Dogra, OD

• Family Nurse Practitioner in San Jose, CA
• Providers in San Jose, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2019; 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.