SHANNON HOUGHTLIN DO
NPI 1053170183
Student in an Organized Health Care Education/Training Program in Fort Pierce, FL

Q: What is Shannon Houghtlin's NPI number?

The NPI number for Shannon Houghtlin is 1053170183. It was assigned to this individual provider in the NPPES registry on March 19, 2024.

Q: What is Shannon Houghtlin's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Houghtlin was last updated on March 19, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 19, 2024PECOS Enrolled

1700 S 23RD ST, FORT PIERCE, FL 34950(772) 468-4554 Get Directions Write a Review

NPPES record last updated: March 19, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Shannon Houghtlin Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON HOUGHTLIN DO (NPI 1053170183) is an individual student in an organized health care education/training program in Fort Pierce, Florida and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053170183

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameSHANNON HOUGHTLINCredential: DO

Location Address1700 S 23RD STFort Pierce, FL 34950-4803

Mailing Address1700 S 23rd StFort Pierce, FL 34950-4803 · (772) 468-4554

Phone(772) 468-4554

Sole ProprietorYes

Enumeration DateMarch 19, 2024

NPPES CertifiedMarch 19, 2024

✔ NPI 1053170183 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1700 S 23RD ST, Fort Pierce, FL 34950

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannon Houghtlin Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHERIDAN ROP SERVICES OF FLORIDA, INC.

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