Individual provider Active NPI

Shannon Brennan, NP

  • Nurse Practitioner
  • South Ogden, UT
National Provider Identifier
1962869552
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
283634-4405 Issued in UT
Practice address
1525 E 6000 S
South Ogden, UT 84405-7144
Phone
(801) 337-5800
Fax
(801) 337-5809
NPI assigned
Jan 27, 2016
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 283634-4405 UT Primary

Addresses

Primary practice location

1525 E 6000 S
South Ogden, UT 84405-7144

Mailing address

PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3500

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20160315002914 UT Practitioner - Nurse Practitioner 8729384870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Circle of Life IncGroup PAC ID 5193703544, 10 clinicians

Practice addresses (Care Compare)

1525 E 6000
Suite a
Ogden, UT 84405-7149
Phone (801) 337-5800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Circle of Life Inc CurrentSince Jan 30, 2016 Accepting new patients
Ogden Clinic PC Nurse Practitioner Past Accepting new patients

Locations

1525 E 6000 S
South Ogden, UT 84405
Phone (801) 337-5800

1525 E 6000 S
Ste A
South Ogden, UT 84405
Phone (801) 337-5800

Interoperability endpoints

  • Direct secure messaging: mindfulmedical.shannonbrennan@156096.advancedmd-direct.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1453852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1962869552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-475-3500",
            "fax_number": "801-475-3494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E 6000 S",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844057144",
            "telephone_number": "801-337-5800",
            "fax_number": "801-337-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "SHANNON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-27",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "283634-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Ogden, UT

Sources for this page

Verify at the official NPI Registry.