Shannon Pitvorec, ATC, LAT, CEAS II

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT681 Issued in NM

Practice address

9513 Claremont Ave NE
Albuquerque, NM 87112-1341

Phone

(904) 327-5005

NPI assigned

Jun 17, 2025

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

Other names 1

• Shannon Nickels Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1750118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1891681599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9513 CLAREMONT AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871121341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9513 CLAREMONT AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871121341",
            "telephone_number": "904-327-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITVOREC",
        "first_name": "SHANNON",
        "credential": "ATC, LAT, CEAS II",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NM",
            "license": "AT681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "NICKELS",
            "credential": "ATC, LAT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joseph Edward Pitluck III, DDS
• David G. Pitonzo, P.A.-C., PH.D.
• Bryce Anne Pittenger, LPCC
• Scout Rae Pittman, LMSW
• Karoline Pitts
• Karen R Pitzen, LCSW
• Neil Douglas Pivar, MD
• Pivot ABA LLC
• Pivot LLC (Pivot Recovery Resources LLC)
• Pivots Potential LLC

• Athletic Trainer in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Athletic Trainer in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.