Individual provider Active NPI

Shannon K Donegan, FNP

  • Family Nurse Practitioner
  • Los Altos Hills, CA
National Provider Identifier
1720706880
Registry record updated Dec 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704219737 Issued in MI
Practice address
14355 Miranda Way
Los Altos Hills, CA 94022-2032
Phone
(734) 417-4370
NPI assigned
Aug 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2023

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 4704219737 MI Primary

Addresses

Primary practice location

14355 Miranda Way
Los Altos Hills, CA 94022-2032

Mailing address

14355 Miranda Way
Los Altos Hills, CA 94022-2032
Phone (734) 417-4370

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704219737MIMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: shannon.donegan.1@27069.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701561600000",
    "number": "1720706880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14355 MIRANDA WAY",
            "city": "LOS ALTOS HILLS",
            "state": "CA",
            "postal_code": "940222032",
            "telephone_number": "734-417-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14355 MIRANDA WAY",
            "city": "LOS ALTOS HILLS",
            "state": "CA",
            "postal_code": "940222032",
            "telephone_number": "734-417-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONEGAN",
        "first_name": "SHANNON",
        "middle_name": "K",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-16",
        "last_updated": "2023-12-03",
        "certification_date": "2023-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704219737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Altos Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2023; 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.