Alexandria Nicole Shannon

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

2210 Main Dr
Springdale, AR 72762-6802

Phone

(479) 856-6397

Fax

(479) 856-6412

NPI assigned

Nov 10, 2022

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Kids for the Future Rogers, Inc.

  • Developmental Disabilities Clinic/Center
  • Rogers, AR
  • NPI 1508037870
  NPD (past)
• Kidscorp of Fayetteville, Inc

  • Developmental Disabilities Clinic/Center
  • Springdale, AR
  • NPI 1790124659
  NPD (past)

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1821706508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727570130",
            "telephone_number": "479-856-6397",
            "fax_number": "479-856-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 MAIN DR",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626802",
            "telephone_number": "479-856-6397",
            "fax_number": "479-856-6412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3307 N Dixieland Rd",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727566816",
            "country_code": "US",
            "telephone_number": "479-986-5150",
            "fax_number": "479-986-5191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "ALEXANDRIA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Andrew Sewell, D.C.
• Regina Kay Sewell, D.C.
• Kasilynn Alese Shaddy
• Sarah Shaddy
• Carol Lynn Shafer, RN
• Aneet K Sharma, MD, DDS
• Alyssa Shaw, LPC
• Calista Edith Shaw, MHPP
• Benjamin Shearer
• Craig Anthony Sheedy, M.D.

• Developmental Therapist in Springdale, AR
• Providers in Springdale, AR by specialty
• Developmental Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.