Shannon Allen

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95002684 Issued in CA

Practice address

7117 Brockton Ave
Riverside, CA 92506-2658

Phone

(951) 782-3739

NPI assigned

Jul 29, 2015

Last updated

Feb 24, 2020By the provider in NPPES

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 Sprague Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sallen96810@direct.llu.edu

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.

• County of Riverside

  • Federally Qualified Health Center (FQHC)
  • Indio, CA
  • NPI 1023122967
  Medicare reassignment NPD
• Riverside Medical Clinic, Inc

  dba Riverside Medical Clinic

  • Dermatology Physician
  • Riverside, CA
  • NPI 1720183403
  Medicare reassignment NPD
• County of Riverside

  • Federally Qualified Health Center (FQHC)
  • Perris, CA
  • NPI 1891352944
  NPD
• Riverside Medical Clinic, Inc

  dba Riverside Medical Clinic

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1730180415
  NPD
• Riverside Medical Clinic, Inc

  dba Riverside Medical Clinic

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1871902452
  NPD

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1982089173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062658",
            "telephone_number": "951-782-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062658",
            "telephone_number": "951-782-3739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "880 N State St",
            "address_purpose": "LOCATION",
            "city": "Hemet",
            "state": "CA",
            "postal_code": "925431459",
            "country_code": "US",
            "telephone_number": "951-766-2450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-29",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95002684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "SPRAGUE",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Deborah Michelle Allen, RN
• Kiana M Allen
• Nathan Allen
• Neville Keith Allen, PEER SUPPORT
• Nicole Allen
• Shelby Anne Allen
• Alleviate Care-Inland Valley LLC (Inland Valley Hospice)
• Alliance Care Hospice,Inc.
• Alliance Sleep Diagnostics
• Alliance Sleep Diagnostics,LLC

• Family Nurse Practitioner in Riverside, CA
• Providers in Riverside, 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 Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.