=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245827674
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHANNON FIELDING RN-MSN, FNP-C, CPE
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/31/2020
-----------------------------------------------------
Last Update Date | 05/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 899 N LOGAN ST STE 407
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80203-3155
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-485-5293
-----------------------------------------------------
Fax | 888-710-3082
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 899 N LOGAN ST STE 407
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80203-3155
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-485-5293
-----------------------------------------------------
Fax | 888-710-3082
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 1630524
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225500000X
-----------------------------------------------------
Taxonomy Name | Respiratory/Developmental/Rehabilitative Specialist/Technologist
-----------------------------------------------------
License Number | 07-07024
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | 0022025
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 363LP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Nurse Practitioner
-----------------------------------------------------
License Number | APN.1000756-NP
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APN.1000756-NP
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------