Individual provider Active NPI

Jordan Shanahan, FNP-C

  • Family Nurse Practitioner
  • Aurora, IL
National Provider Identifier
1720551567
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209017719 Issued in IL
Practice address
400 N Highland Ave
Aurora, IL 60506-3814
Phone
(630) 892-4355
NPI assigned
Jan 4, 2019
Last updated
Jan 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209017719 IL Primary

Addresses

Primary practice location

400 N Highland Ave
Aurora, IL 60506-3814

Mailing address

400 N Highland Ave
Aurora, IL 60506-3814
Phone (630) 978-2532

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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1720551567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N HIGHLAND AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605063814",
            "telephone_number": "630-978-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N HIGHLAND AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605063814",
            "telephone_number": "630-892-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "JORDAN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-04",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209017719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.