SHANNON DOCKHAM FNP-C
NPI 1679139943
Nurse Practitioner - Family in San Jose, CA
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
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shannon Dockham Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Shannon Dockham reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Jose, CA 95123
- Reassigned Medicare billing, California enrollment
- 15 clinicians in this Medicare group
Concord, CA 94520
- Reassigned Medicare billing, California enrollment
- 530 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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.
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.
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.
Which organizations bill Medicare for Shannon Dockham's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shannon Dockham reassigns Medicare benefits to 2 organizations: California Emergency Physicians (San Jose, CA) and Contra Costa County (Concord, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shannon Dockham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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.
# Shannon Dockham, FNP-C · NPI 1679139943
Family physician in San Jose, California. Individual provider, active in the CMS NPPES registry since May 13, 2019.
## Identity
- **NPI:** 1679139943 (Entity type: Individual)
- **Enumerated:** May 13, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95007952 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 554 BLOSSOM HILL RD, San Jose, CA 95123-3212
- **Phone:** (408) 281-2772
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): California Emergency Physicians (NPI 1922020940, San Jose, CA); Contra Costa County (NPI 1023188489, Concord, CA) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 22, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1679139943) · Data from the CMS NPPES public registry.