Shannon Deckman, RN

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

5540 107TH Ter E
Parrish, FL 34219-4530

Phone

(215) 620-0589

NPI assigned

Dec 18, 2013

Last updated

Jul 17, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1992126817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5540 107TH TER E",
            "city": "PARRISH",
            "state": "FL",
            "postal_code": "342194530",
            "telephone_number": "215-620-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5540 107TH TER E",
            "city": "PARRISH",
            "state": "FL",
            "postal_code": "342194530",
            "telephone_number": "215-620-0589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKMAN",
        "first_name": "SHANNON",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-18",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9350517",
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Amanda Daka, PA-C
• Brooke Davis, LCSW
• William W Davis
• Angelina Deak, D.O
• Deb's Helping Hands, LLC
• Defenders for You Inc
• Amanda Rae Delcastillo, LMT, PT, CST-D
• Destination DNTL, P.a. (Destination Dental)
• Debbie Dieter, PT
• Jeannene L Dieter, O.D.

• Developmental Therapist in Parrish, FL
• Providers in Parrish, FL by specialty
• Developmental Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.