Individual provider Active NPI

Shannon Sherman

  • Obstetrics & Gynecology Nurse Practitioner
  • Chandler, AZ
National Provider Identifier
1770919391
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
5366 Issued in AZ
Practice address
2545 W Frye Rd Ste 5
Chandler, AZ 85224-6273
Phone
(480) 821-3600
Fax
(480) 821-3610
NPI assigned
Sep 16, 2013
Last updated
Sep 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 5366 AZ Primary

Addresses

Primary practice location

2545 W Frye Rd Ste 5
Chandler, AZ 85224-6273

Mailing address

14780 W Mountain View Blvd
Ste 110
Surprise, AZ 85374-7280
Phone (480) 821-3600

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
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1770919391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14780 W MOUNTAIN VIEW BLVD",
            "address_2": "STE 110",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747280",
            "telephone_number": "480-821-3600",
            "fax_number": "480-821-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 W FRYE RD STE 5",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246273",
            "telephone_number": "480-821-3600",
            "fax_number": "480-821-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "SHANNON",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-16",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "AZ",
            "license": "5366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.