Shannon Lyn Manley, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95010607 Issued in CA

Practice address

3900 Piedmont Ave
Oakland, CA 94611-5352

Phone

(415) 432-7899

Fax

(510) 899-7101

NPI assigned

Feb 9, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Shannon Jordan Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Urgent Care Plus Telehealth IncGroup PAC ID 0941630123, 27 clinicians

Infusion Express of California IncGroup PAC ID 2365720604, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Petaluma Valley Hospital Hospital, Petaluma, CA, CCN 050136

Merit-based Incentive Payment System (MIPS)

Final score

91.9 of 100Reported as group

Quality

81.89

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.manley@hpg.eclinicaldirectplus.com
• Direct secure messaging: shannon.manley.1@21754.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 and National Provider Directory roles.

• Infusion Express of California Inc

  • Infusion Therapy Clinic/Center
  • Fremont, CA
  • NPI 1447604525

  CA

  Medicare reassignment Care Compare group NPD
• Urgent Care Plus Telehealth Inc

  • Urgent Care Clinic/Center
  • Benicia, CA
  • NPI 1568082774

  CA

  Medicare reassignment Care Compare group NPD
• Norcal Healthconnect LLC

  • Multi-Specialty Clinic/Center
  • Healdsburg, CA
  • NPI 1720695547

  CA

  Medicare reassignment NPD
• Norcal Healthconnect LLC

  • Critical Access Hospital
  • Healdsburg, CA
  • NPI 1861009672

  CA

  Medicare reassignment NPD
• Urgent Care Plus Telehealth Inc

  • Urgent Care Clinic/Center
  • Sonoma, CA
  • NPI 1326759739
  Care Compare group NPD (past)
• Urgent Care Plus Telehealth Inc

  • Urgent Care Clinic/Center
  • Benicia, CA
  • NPI 1356966816
  Care Compare group
• Urgent Care Plus Telehealth Inc

  • Urgent Care Clinic/Center
  • Napa, CA
  • NPI 1992320451
  Care Compare group
• Norcal Healthconnect LLC

  • General Acute Care Hospital
  • Petaluma, CA
  • NPI 1235162645
  NPD
• Norcal Healthconnect LLC

  • Critical Access Hospital
  • Healdsburg, CA
  • NPI 1295342012
  NPD
• Urgent Care Plus Telehealth Inc

  • Urgent Care Clinic/Center
  • Petaluma, CA
  • NPI 1447082045
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Norcal Healthconnect LLC

  • General Acute Care Hospital
  • Petaluma, CA
  • NPI 1235162645

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1549670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1780149153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "ATTN: CREDENTIALING/PAYER ENROLLMENT",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 PIEDMONT AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115352",
            "telephone_number": "415-432-7899",
            "fax_number": "510-899-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANLEY",
        "first_name": "SHANNON",
        "middle_name": "LYN",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-09",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95010607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "JORDAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ronald Patrick Mangru, REGISTERED NURSE
• Iona Mani
• Ernest Maningding, MD, MPH
• Reshma Manjiyani, LCSW
• Richard Shannon Manley III, DC
• Carmelinda Martin Mann, PH.D.
• Jeffrey A. Mann, M.D.
• Roger A. Mann, M.D.
• David Manner
• Avon Day Manney

• All providers in Oakland, CA
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.