Shannon Lee De Angelis

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

548 SW 13TH St
Bend, OR 97702-3184

Phone

(541) 388-8459

NPI assigned

Jan 22, 2024

Last updated

Jan 22, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Rimrock Trails Treatment Services

  dba Rimrock Trails ATS

  • Children's Substance Abuse Rehabilitation Facility
  • Prineville, OR
  • NPI 1194873406
  NPD
• The Redmond Family Medicine Center

  • Family Medicine Physician
  • Redmond, OR
  • NPI 1639256258
  NPD (past)

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1851152300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20295 MARINER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037069",
            "telephone_number": "503-840-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 SW 13TH ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023184",
            "telephone_number": "541-388-8459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE ANGELIS",
        "first_name": "SHANNON",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Dawson, D.O.
• Carolyn K Day, M.D.
• Chelsea Nichole Day, DPT, PT
• James M Dayton, MD
• Jose De Alba
• Christina Denys De Benedetti, BS
• Anya De la Motte, N.D
• Anna-Theresa Maria De Roover, L.M.T.
• Thomas De Santis
• Kathleen Ann De Vito

• Peer Specialist in Bend, OR
• Providers in Bend, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.