{
"Npi": {
"NPI": "1356520506",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "OFFERMAN",
"FirstName": "SHANNON",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "11516 N PORT WASHINGTON RD STE 107",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MEQUON",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53092-3478",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "262-241-5040",
"MailingAddressFaxNumber": "262-241-5261",
"FirstLinePracticeLocationAddress": "19333 W NORTH AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BROOKFIELD",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "53045-4132",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "262-780-4100",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/24/2007",
"LastUpdateDate": "10/30/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "2085R0001X",
"TaxonomyName": "Radiation Oncology Physician",
"LicenseNumber": "57013998",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085R0001X",
"TaxonomyName": "Radiation Oncology Physician",
"LicenseNumber": "55615-20",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}