Individual provider Active NPI

Shannon Stewart, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lakewood, CO
National Provider Identifier
1740908961
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
C-APN.0004437 Issued in CO
Practice address
1090 S. Wadsworth Blvd. Unit C
#3108
Lakewood, CO 80226-4350
Phone
(720) 797-5186
Fax
(720) 405-4313
NPI assigned
Aug 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 00004437 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X C-APN.0004437-C-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X C-APN.0004437 CO Primary

Addresses

Primary practice location

1090 S. Wadsworth Blvd. Unit C
#3108
Lakewood, CO 80226-4350

Mailing address

1090 S. Wadsworth Blvd. Unit C
#3108
Lakewood, CO 80226-4350
Phone (720) 797-5186

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
00004437COMDPsychiatric/Mental Health Nurse Practitioner
C-APN.0004437COMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Owl and Eagle Enterprises, LLC Psychiatric/Mental Health PastSince Apr 24, 2022 Accepting new patients
Owl and Eagle Enterprises, LLC Psychiatric/Mental Health PastSince Feb 1, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: stewartpsychiatry.shannonstewart@160750.advancedmd-direct.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1740908961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 S. WADSWORTH BLVD. UNIT C",
            "address_2": "#3108",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802264350",
            "telephone_number": "720-797-5186",
            "fax_number": "720-405-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 S. WADSWORTH BLVD. UNIT C",
            "address_2": "#3108",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802264350",
            "telephone_number": "720-797-5186",
            "fax_number": "720-405-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "SHANNON",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "00004437",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0004437-C-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0004437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; 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.