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SHANNEN DEANNA KIM
NPI 1164000691
Student in an Organized Health Care Education/Training Program in Stanford, CA

Active since March 29, 2021PECOS Enrolled
300 PASTEUR DR, STANFORD, CA 94305(650) 723-5948 Get Directions Write a Review

NPPES record last updated: December 10, 2024. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Dec 10, 2024, Mar 29, 2021 (2 updates tracked since 2021).

About Shannen Deanna Kim NPPES

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

SHANNEN DEANNA KIM (NPI 1164000691) is an individual student in an organized health care education/training program in Stanford, California and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164000691
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameSHANNEN DEANNA KIM
Location Address300 PASTEUR DRStanford, CA 94305-2200
Mailing Address300 Pasteur DrStanford, CA 94305-2200
Phone(650) 723-5948
Sole ProprietorNo
Enumeration DateMarch 29, 2021
Last NPPES UpdateDecember 10, 20242 updates tracked since enumeration
NPPES CertifiedDecember 10, 2024
✔ NPI 1164000691 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.
300 PASTEUR DR, Stanford, CA 94305
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannen Deanna Kim 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.

PRISTA CHARUWORN MD
Internal Medicine (Gastroenterology)
300 PASTEUR DR, ALWAY BUILD M211, MC 5187
STANFORD, CA 94305
Santa Clara County (650) 723-6661
ANDREW CHARLES PICEL M.D
Radiology (Vascular & Interventional Radiology)
300 PASTEUR DR
STANFORD, CA 94305
Santa Clara County (650) 723-4000
MATTHEW A WRIGHT M.D. PH.D.
Psychiatry & Neurology (Psychiatry)
300 PASTEUR DR
STANFORD, CA 94305
Santa Clara County (650) 723-4000
DR. QUAZI ZUBAIR AL-TARIQ M.D.
Radiology (Diagnostic Radiology)
300 PASTEUR DR
STANFORD, CA 94305
Santa Clara County (650) 723-4000
ANGIE DEE MURKINS NP
Nurse Practitioner
300 PASTEUR DR
STANFORD, CA 94305
Santa Clara County (650) 723-4000
DR. JAMSHID GHAJAR MD PHD
Neurological Surgery
300 PASTEUR DR
STANFORD, CA 94305
Santa Clara County (650) 723-4000
SARA BAKHTARY M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
300 PASTEUR DR, LANE 235
STANFORD, CA 94305
Santa Clara County (650) 723-5252
YU KUANG LAI MD
Internal Medicine (Critical Care Medicine)
300 PASTEUR DR
STANFORD, CA 94305
Santa Clara County (650) 723-4000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannen Kim's NPI number?

The NPI number for Shannen Kim is 1164000691. It was assigned to this individual provider in the NPPES registry on March 29, 2021.

Where is Shannen Kim located?

Shannen Kim practices at 300 Pasteur Dr, Stanford, CA 94305. The listed phone number is (650) 723-5948.

What is Shannen Kim's specialty?

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

Is Shannen Kim enrolled in Medicare?

Yes. Shannen Kim is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shannen Kim was last updated on December 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.