Shannon Taylor Smith, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

0024172592 Issued in VA

Practice address

171 Kempsville Rd BLDG a
Norfolk, VA 23502-4700

Phone

(757) 668-6550

Fax

(757) 668-6545

NPI assigned

Jan 4, 2016

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 VA

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

Certified Pediatric Nurse Practitioner, Nurse Practitioner

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.

• Children'S Surgical Specialty Group, Inc

  • Pediatric Surgery Physician
  • Norfolk, VA
  • NPI 1245248947
  Medicare reassignment

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

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1023474251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 CHILDRENS LN",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071910",
            "telephone_number": "757-668-7878",
            "fax_number": "757-668-7883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 KEMPSVILLE RD BLDG A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024700",
            "telephone_number": "757-668-6550",
            "fax_number": "757-668-6545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Discovery Dr",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233203871",
            "country_code": "US",
            "telephone_number": "757-668-6550",
            "fax_number": "757-668-6545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 Childrens Ln",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071910",
            "country_code": "US",
            "telephone_number": "757-668-6550",
            "fax_number": "757-668-6545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2021 Concert Dr",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234568082",
            "country_code": "US",
            "telephone_number": "757-668-6550",
            "fax_number": "757-668-6545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1924 Landstown Centre Way",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234561624",
            "country_code": "US",
            "telephone_number": "757-668-6550",
            "fax_number": "757-668-6545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11783 Rock Landing Dr",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064431",
            "country_code": "US",
            "telephone_number": "757-668-6550",
            "fax_number": "757-668-6545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANNON",
        "middle_name": "TAYLOR",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-04",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024172592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penny Chrystal Smith, NNP
• Philip C Smith, M.D., PHD
• Ray M Smith III, MD
• Raymond Smith, LCSW-C, , LCSW, QCSW
• Rodrica Smith
• Sheila Marie Smith, CRNA
• Stacey S Smith, LCSW
• Tashia Smith, LCSW
• Tawanda Smith, LCSW
• Thomas Gregory Smith, DDS

• Pediatric Nurse Practitioner in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Pediatric Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.