Shannon Kathleen Oconnor

Primary specialty

SpecialistTaxonomy code 174400000X

License

2292834 Issued in NY

Practice address

31955 State Route 20
Suite 3
Oak Harbor, WA 98277-5211

Phone

(718) 772-3147

NPI assigned

Mar 12, 2014

Last updated

Nov 7, 2018By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

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  • NPI 1639891922
  NPD (past)

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1821414996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31955 STATE ROUTE 20",
            "address_2": "SUITE 3",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982775211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31955 STATE ROUTE 20",
            "address_2": "SUITE 3",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982775211",
            "telephone_number": "718-772-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCONNOR",
        "first_name": "SHANNON",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-12",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "2292834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oak Harbor Pediatric Dentistry
• Oak Harbor Primary Care PLLC (North Island Medical)
• Oak Harbor Retirement Community LLC (Regency on Whidbey)
• Oak Harbor School District #201
• Taylor Michelle Oberg, RN
• Sandra Kaye Oldemeyer, LPN
• Lorenzo Quentrel Olive, M.D.
• Linsey Monique Olsen, BS
• Olson Pediatric Dentistry
• Larayne Olson, ARNP

• Specialist in Oak Harbor, WA
• Providers in Oak Harbor, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2018; 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.