Shannon Lyons Boffeli, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

291176 Issued in AZ

Practice address

107 E Oak Ave
Flagstaff, AZ 86001-1818

Phone

(928) 779-7880

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Arizona Healthcare CorporationGroup PAC ID 3577473362, 391 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023

Merit-based Incentive Payment System (MIPS)

Final score

82.13 of 100Reported as group

Quality

66.85

Promoting interoperability

99

Improvement activities

40

Cost

74.4

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Northern Arizona Healthcare Corporation

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1669914552
  Medicare reassignment Care Compare group NPD
• Flagstaff Pathology Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Flagstaff, AZ
  • NPI 1306205612
  NPD
• Northern Arizona Healthcare Corporation

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1235732702
  NPD
• Orthopaedic Spine Surgeons

  • Orthopaedic Surgery of the Spine Physician
  • Salt Lake City, UT
  • NPI 1245474139
  NPD (past)
• Southwest Medical Associates, Inc

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1659346005
  NPD (past)

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

• Flagstaff Medical Center

  • Air Ambulance
  • Flagstaff, AZ
  • NPI 1427234111

  Hospital

  Care Compare affiliation
• Flagstaff Medical Center

  • Land Ambulance
  • Flagstaff, AZ
  • NPI 1518143205

  Hospital

  Care Compare affiliation
• Flagstaff Medical Center

  • Psychiatric Hospital Unit
  • Flagstaff, AZ
  • NPI 1649370875
  Care Compare affiliation
• Flagstaff Medical Center

  • General Acute Care Hospital
  • Flagstaff, AZ
  • NPI 1780635078
  Care Compare affiliation

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1861582447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-213-6235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E OAK AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011818",
            "telephone_number": "928-779-7880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "590 Wakara Way",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841081200",
            "country_code": "US",
            "telephone_number": "801-587-7100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2231 W. Charleston Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "89102",
            "country_code": "US",
            "telephone_number": "702-383-2662",
            "fax_number": "702-383-2682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOFFELI",
        "first_name": "SHANNON",
        "middle_name": "LYONS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "374115-4408",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APRN002370",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "291176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Block, RN
• Blue Gems ABA Az LLC
• Darren Blue
• Deborah Bodin, P.T., M.P.T.
• Adam Keith Boettcher, M.D.
• Audrey Bohlmann
• James Dean Bohn, CRNA
• Nadine Bohn, RDH
• William Boland
• Bolt Ons

• Nurse Practitioner in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.