Shannon D Stadelmann, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95004762 Issued in CA

Practice address

477 N El Camino Real
Suite 208a
Encinitas, CA 92024-1328

Phone

(760) 479-3900

Fax

(760) 634-4845

NPI assigned

Aug 19, 2016

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

Other names 1

• Shannon Doersam Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sdoersam19688@scrippshlth.medalliesdirect.net

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.

• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1922553908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "address_2": "MAIL DROP 4S-205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "760-479-3900",
            "fax_number": "760-634-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL",
            "address_2": "SUITE 208A",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241328",
            "telephone_number": "760-479-3900",
            "fax_number": "760-634-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STADELMANN",
        "first_name": "SHANNON",
        "middle_name": "D",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-19",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95004762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "DOERSAM",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew Sperle
• Mary Elizabeth Spiegel, M.D.
• Spinezone Medical Fitness, Inc.
• Chandra Leah Spring-Robinson, DO
• Stacy D. Tompkins, M.D., Inc.
• Claire Stagnaro, PSYD
• Joseph Alex Stankowicz I
• Holly Colleen Staples, FNP
• Kerri Starr, NP
• Nancy A Staycer, LCSW

• Family Nurse Practitioner in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.