Shannon Raquel Miles, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

235897 Issued in AZ

Practice address

287 E Hunt Hwy Ste 105
San Tan Valley, AZ 85143-5096

Phone

(480) 677-8282

NPI assigned

Jul 3, 2019

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.miles.p1@direct.itsofaz.nextgenshare.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.

• Good Health Medical, PLLC

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1144764432

  Single Specialty

  Medicare reassignment NPD
• Community Medical Services Arizona-Private, LLC

  • Methadone Clinic
  • Casa Grande, AZ
  • NPI 1154822062
  NPD
• Good Health Medical, PLLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1023828431
  NPD
• Good Health Medical, PLLC

  • Family Medicine Physician
  • Gilbert, AZ
  • NPI 1679857825

  Single Specialty

  NPD

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1881256378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 N 36TH ST STE 126",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850183456",
            "telephone_number": "623-329-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 E HUNT HWY STE 105",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851435096",
            "telephone_number": "480-677-8282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12341 W Corrine Dr",
            "address_purpose": "LOCATION",
            "city": "El Mirage",
            "state": "AZ",
            "postal_code": "853355224",
            "country_code": "US",
            "telephone_number": "623-329-0551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILES",
        "first_name": "SHANNON",
        "middle_name": "RAQUEL",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "AZ",
            "license": "165853",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "235897",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "235897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lourdes E Melendez-Oetinger, MD
• Menage Life LLC
• Jamie Lynn Mendez, RN
• Grace Mendoza, MSC, LPC
• Mental Health Refreshed LLC
• Lauren Miller
• Karla Miranda
• MK Senior Care LLC
• Brandon Arthur Moak
• Joel Mark Montemayor, ABO,NCLE,LDO

• Family Nurse Practitioner in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.