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SHANNON DOCKHAM FNP-C
NPI 1679139943
Nurse Practitioner - Family in San Jose, CA

Active since May 13, 2019PECOS Enrolled
554 BLOSSOM HILL RD, SAN JOSE, CA 95123(408) 281-2772 Get Directions Write a Review

NPPES record last updated: June 22, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 22, 2019, May 13, 2019 (2 updates tracked since 2019).

About Shannon Dockham Fnp-c NPPES

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

SHANNON DOCKHAM FNP-C (NPI 1679139943) is an individual family provider in San Jose, California, licensed in California (95007952) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679139943
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHANNON DOCKHAMCredential: FNP-C
Location Address554 BLOSSOM HILL RDSan Jose, CA 95123-3212
Mailing Address2100 Powell St, Ste 400Emeryville, CA 94608-1826 · (510) 350-2600
Phone(408) 281-2772
Sole ProprietorNo
Enumeration DateMay 13, 2019
Last NPPES UpdateJune 22, 20192 updates tracked since enumeration
✔ NPI 1679139943 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95007952
554 BLOSSOM HILL RD, San Jose, CA 95123
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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)

Shannon Dockham Fnp-c 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95123 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$106.47 typical visit price
range $70.37 – $206.04
Typical copayment $26.61 (range $17.59 – $51.51)
Most-billed visit code 99203
Established Patient
$121.77 typical visit price
range $23.96 – $169.60
Typical copayment $30.44 (range $5.99 – $42.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier12 claims12 services$3.15 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 6

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

MONA SHAH
Physical Therapist
554 BLOSSOM HILL RD
SAN JOSE, CA 95123
Santa Clara County (408) 281-2772
KRISTINE HULME
Physical Therapist
554 BLOSSOM HILL RD
SAN JOSE, CA 95123
Santa Clara County (408) 281-2772
JENNIFER LYNN MENDONCA P.T.A.
Physical Therapy Assistant
554 BLOSSOM HILL RD
SAN JOSE, CA 95123
Santa Clara County (408) 360-8490
SAMUEL JOSEPH CIPOLETTI M.D
Internal Medicine
554 BLOSSOM HILL RD
SAN JOSE, CA 95123
Santa Clara County (408) 281-2772
CALIFORNIA EMERGENCY PHYSICIANS
Physical Therapist
554 BLOSSOM HILL RD
SAN JOSE, CA 95123
Santa Clara County (408) 360-8490
CALIFORNIA EMERGENCY PHYSICIANS
Family Medicine
554 BLOSSOM HILL RD
SAN JOSE, CA 95123
Santa Clara County (408) 281-2772

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 Shannon Dockham's NPI number?

The NPI number for Shannon Dockham is 1679139943. It was assigned to this individual provider in the NPPES registry on May 13, 2019.

Where is Shannon Dockham located?

Shannon Dockham practices at 554 Blossom Hill Rd, San Jose, CA 95123. The listed phone number is (408) 281-2772.

What is Shannon Dockham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shannon Dockham enrolled in Medicare?

Yes. Shannon Dockham is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shannon Dockham was last updated on June 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.