Organization Active NPI

Shannon Winters DC PA

  • Chiropractor
  • Stuart, FL
National Provider Identifier
1942586680
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9062 Issued in FL
Legal business name
SHANNON WINTERS DC PA
Practice address
2682 SE Willoughby Blvd
Suite 101
Stuart, FL 34994-4738
Phone
(772) 924-9100
Fax
(772) 219-1110
NPI assigned
Oct 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Authorized official

Name
Dr. Shannon Winters, D.C.NPI 1275758823
Title
Owner
Phone
(772) 924-9100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH9062 FL Primary

Addresses

Primary practice location

2682 SE Willoughby Blvd
Suite 101
Stuart, FL 34994-4738

Mailing address

2682 SE Willoughby Blvd
Suite 101
Stuart, FL 34994-4738
Phone (772) 924-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120605000087 FL Part B Supplier - Clinic/Group Practice 9436313400 Receives reassigned benefits from 1 practitioner
Practice locations: Stuart, FL

National Provider Directory

National Provider Directory

Locations

2682 SE Willoughby Blvd
Ste 101
Stuart, FL 34994
Phone (772) 240-1619

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319587200000",
    "number": "1942586680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2682 SE WILLOUGHBY BLVD",
            "address_2": "SUITE 101",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944738",
            "telephone_number": "772-924-9100",
            "fax_number": "772-219-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2682 SE WILLOUGHBY BLVD",
            "address_2": "SUITE 101",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944738",
            "telephone_number": "772-924-9100",
            "fax_number": "772-219-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON WINTERS DC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-26",
        "last_updated": "2011-10-26",
        "status": "A",
        "authorized_official_last_name": "WINTERS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-924-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.