Active NPI
Shannan Roddy, DO
- General Practice Physician
- Pensacola, FL
National Provider Identifier
1720548951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 0101276252
- Practice address
- 340 Hulse Rd
Pensacola, FL 32508-1089 - Phone
- (850) 452-2933
- NPI assigned
- Mar 22, 2019
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 0101276252 | VA | Primary |
Addresses
Primary practice location
340 Hulse Rd
Pensacola, FL 32508-1089
Mailing address
340 Hulse Rd
Pensacola, FL 32508-1089
Phone (850) 452-2933
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101276252 | VA | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western University of Health Sciences | 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.
-
dba WesternU Patient Care
- Adult Medicine Physician
- Lebanon, OR
- NPI 1639555170
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685577600000",
"number": "1720548951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 HULSE RD",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325081089",
"telephone_number": "850-452-2933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 HULSE RD",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325081089",
"telephone_number": "850-452-2933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODDY",
"first_name": "SHANNAN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-22",
"last_updated": "2023-06-01",
"certification_date": "2023-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "VA",
"license": "0101276252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
- Jason R Rocha, M.D.
- Rochetto Counseling Services, PLLC (All Moments Counseling)
- Alexandria A Rochetto, LMHC
- Aliece Dillard Rockwell, ARNP
- Rocky Mountain Holdings, LLC (Air Life Florida)
- Ellen B Rodman, DO
- Rodney W Schulze DC PA
- Gabriel Jose Rodriguez Tellado, M.D.
- Alexander Mark Rodriguez, MD
- Amanda Rodriguez, CNM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.