Shan Ni, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP017236 Issued in PA

Practice address

3401 N Broad St
Philadelphia, PA 19140-5103

Phone

(215) 707-3008

Fax

(215) 707-1387

NPI assigned

May 12, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• LCH Health and Community Services

  • Federally Qualified Health Center (FQHC)
  • West Grove, PA
  • NPI 1063901205
  Medicare reassignment NPD
• Temple Faculty Practice Plan Inc

  dba Temple Faculty Anesthesiology Associates

  • Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1881176949
  Medicare reassignment NPD
• LCH Health and Community Services

  • Federally Qualified Health Center (FQHC)
  • Kennett Square, PA
  • NPI 1285984476
  NPD
• LCH Health and Community Services

  • Federally Qualified Health Center (FQHC)
  • Oxford, PA
  • NPI 1811587512
  NPD
• Temple Faculty Practice Plan, Inc

  dba Temple Faculty Radiology Associates

  • Diagnostic Radiology Physician
  • Philadelphia, PA
  • NPI 1720561186
  NPD
• Temple Faculty Practice Plan Inc

  dba Temple Faculty Multi-Specialty at NJ

  • Urology Physician
  • Voorhees, NJ
  • NPI 1407638794
  NPD
• Croft Medical Services, P.C.

  • Obesity Medicine (Preventive Medicine) Physician
  • Coatesville, PA
  • NPI 1174416952
  NPD (past)
• Planned Parenthood Keystone

  • Clinic/Center
  • Reading, PA
  • NPI 1568639029
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1013444769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-3008",
            "fax_number": "215-707-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-3008",
            "fax_number": "215-707-1387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "48 S 4th St",
            "address_purpose": "LOCATION",
            "city": "Reading",
            "state": "PA",
            "postal_code": "196021047",
            "country_code": "US",
            "telephone_number": "610-481-0481",
            "fax_number": "610-481-0486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NI",
        "first_name": "SHAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-12",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Nhan, M.D.
• Tywanya Nhaway
• Hong Ni, DMD
• Richard Ni, DMD
• Roselind Ni
• Niam's Legacy Home & Healthcare Services LLC
• Janice Rae Niangane, PHD
• Lonjete Tabu Nias, LCSW
• Julie Niblock
• Edmund Niboi

• Family Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.