Active NPI
Shannon Warren, DC
- Chiropractor
- Houston, TX
National Provider Identifier
1730182015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 6894
- Practice address
- 2400 Augusta Dr Ste 210
Houston, TX 77057-4989 - Phone
- (713) 953-1356
- Fax
- (713) 278-7885
- NPI assigned
- May 31, 2005
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6894 | TX | Primary |
Addresses
Primary practice location
2400 Augusta Dr Ste 210
Houston, TX 77057-4989
Mailing address
2400 Augusta Dr Ste 210
Houston, TX 77057-4989
Phone (713) 953-1356
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 605684 | Other | TX | BLUE CROSS/BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200515000042 | TX | Practitioner - Chiropractic | 4486085081 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6894 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730182015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 AUGUSTA DR STE 210",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770574989",
"telephone_number": "713-953-1356",
"fax_number": "713-278-7885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 AUGUSTA DR STE 210",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770574989",
"telephone_number": "713-953-1356",
"fax_number": "713-278-7885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARREN",
"first_name": "SHANNON",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-05-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "6894",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "605684",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.