Shawna Anne Victorino, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

462 Issued in AK

Practice address

1867 Airport Way
Suite 140 C
Fairbanks, AK 99701-4007

Phone

(907) 455-7770

Fax

(907) 451-7770

NPI assigned

Sep 19, 2007

Last updated

Jun 12, 2023By 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 AK, TX2 enrollments

Enrollment records 2

Specialty

Chiropractic

Education

Life Chiropractic College, 2001

Medicare assignment

May accept Medicare assignment

Group practices

Tanana Chiefs ConferenceGroup PAC ID 9537050109, 148 clinicians

Discover Chiropractic IncGroup PAC ID 1254416225, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shawna.victorino.1@15989.direct.athenahealth.com

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.

• Discover Chiropractic Inc

  • Chiropractor
  • Fairbanks, AK
  • NPI 1215145263
  Medicare reassignment Care Compare group NPD Authorized official
• Tanana Chiefs Conference

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1821201278

  TX

  Medicare reassignment Care Compare group NPD
• Tanana Chiefs Conference

  • Ambulatory Surgical Clinic/Center
  • Fairbanks, AK
  • NPI 1871332387
  NPD
• White Spruce Medical Inc

  • Naturopath
  • Fairbanks, AK
  • NPI 1215983259

  Chiropractor

  NPD
• Alaska Urological Institute PC

  dba Alaska Medical Specialties

  • Urology Physician
  • Anchorage, AK
  • NPI 1689716185
  NPD (past)

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1740476126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1867 AIRPORT WAY",
            "address_2": "SUITE 140 C",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014007",
            "telephone_number": "907-455-7770",
            "fax_number": "907-451-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1867 AIRPORT WAY",
            "address_2": "SUITE 140 C",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014007",
            "telephone_number": "907-455-7770",
            "fax_number": "907-451-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORINO",
        "first_name": "SHAWNA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-19",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Michelle Vezina
• Via Vita Health Project, Inc.
• Vibrant Vision Care
• Leif Vick, LPC
• Jonathan T Victorino, D.C.
• Lorena G Village-Center-Simon
• Carolyn Mary Villagecenter
• Lisa Villano
• Riley Christine Villegas
• Claudia J Vincent, CT

• Chiropractor in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Chiropractor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.