NPIMap

Individual provider Active NPI

Shannon Bumgardner Standish, FNP-C

  • Nurse Practitioner
  • Gastonia, NC
National Provider Identifier
1013494970
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5010723 Issued in NC
Practice address
920 Cox Rd Ste 201
Gastonia, NC 28054-3435
Phone
(704) 864-8302
Fax
(704) 864-0228
NPI assigned
Jul 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5010723 NC Primary

Addresses

Primary practice location

920 Cox Rd Ste 201
Gastonia, NC 28054-3435

Mailing address

3158 Freedom Dr Ste 3102
Charlotte, NC 28208-0014
Phone (704) 719-7099

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sstandish66476@direct.acumenmd.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181027000117 NC Practitioner - Nurse Practitioner 4587917224 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metrolina Nephrology Associates PAGroup PAC ID 8022916600, 85 clinicians

Practice addresses (Care Compare)

2544 Court Dr
F
Gastonia, NC 28054-3450
Phone (704) 864-8302

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
  • Atrium Health Pineville Hospital, Charlotte, NC, CCN 340098

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5010723NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of the Carolinas, P.a. CurrentSince Sep 19, 2018 Accepting new patients
Metrolina Nephrology Associates, PA CurrentSince Jan 1, 2024 Accepting new patients

Locations

2711 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 342-1900

3158 Freedom Dr
Ste 3102
Charlotte, NC 28208
Phone (704) 731-6857

920 Cox Rd
Ste 201
Gastonia, NC 28054
Phone (704) 772-4455

2544 Court Dr
Ste F
Gastonia, NC 28054
Phone (704) 864-8302

1019 N Lafayette St
Ste 1
Shelby, NC 28150
Phone (704) 481-7904

Interoperability endpoints

  • Direct secure messaging: sstandish66476@direct.acumenmd.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/JCJCBA

Organizations & group practices 2

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1013494970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3158 FREEDOM DR STE 3102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282080014",
            "telephone_number": "704-719-7099",
            "fax_number": "704-971-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 COX RD STE 201",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280543435",
            "telephone_number": "704-864-8302",
            "fax_number": "704-864-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANDISH",
        "first_name": "SHANNON",
        "middle_name": "BUMGARDNER",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5010723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sstandish66476@direct.acumenmd.com",
            "affiliation": "N",
            "endpointDescription": "Acument Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CED",
            "address_1": "920 Cox Rd Ste 201",
            "city": "Gastonia",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280543435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.