Organization Active NPI

Shannon T. Herr, DC, PC

  • Nutrition Chiropractor
  • Williamsville, NY
National Provider Identifier
1972875987
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
10065 Issued in NY
Legal business name
SHANNON T. HERR, DC, PC
Practice address
1967 Wehrle Dr
Suite 12
Williamsville, NY 14221-8452
Phone
(716) 204-8955
Fax
(716) 204-8958
NPI assigned
Feb 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Authorized official

Name
Dr. Shannon Thomas Herr, DCNPI 1235173790
Title
Owner
Phone
(716) 480-5646

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
Nutrition ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NN1001X 10065 NY Primary

Addresses

Primary practice location

1967 Wehrle Dr
Suite 12
Williamsville, NY 14221-8452

Mailing address

1967 Wehrle Dr
Suite 12
Williamsville, NY 14221-8452
Phone (716) 204-8955

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120723000888 NY Part B Supplier - Clinic/Group Practice 8022274802 Receives reassigned benefits from 1 practitioner
Practice locations: Williamsville, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1328572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1972875987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1967 WEHRLE DR",
            "address_2": "SUITE 12",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218452",
            "telephone_number": "716-204-8955",
            "fax_number": "716-204-8958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1967 WEHRLE DR",
            "address_2": "SUITE 12",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218452",
            "telephone_number": "716-204-8955",
            "fax_number": "716-204-8958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON T. HERR, DC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-07",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "HERR",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-480-5646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "NY",
            "license": "10065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.