Individual provider Active NPI

Shannon Leigh Byrne, APN, NP-C, CWOCN

  • Nurse Practitioner
  • Hackensack, NJ
National Provider Identifier
1033631460
Registry record updated Jul 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00742100 Issued in NJ
Practice address
20 Prospect Ave Ste 410
Hackensack, NJ 07601-1941
Phone
(551) 996-4070
Fax
(551) 996-4072
NPI assigned
Jul 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2017

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 26NJ00742100 NJ Primary

Addresses

Primary practice location

20 Prospect Ave Ste 410
Hackensack, NJ 07601-1941

Mailing address

10-05 Backus Rd
Fair Lawn, NJ 07410-1925
Phone (201) 956-2110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20170927003344 NJ Practitioner - Nurse Practitioner 7719251834 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00742100NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kane Wound Care LLC CurrentSince Nov 28, 2022 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Sep 1, 2017 Accepting new patients
Hackensack Surgery and Wound Care LLC CurrentSince Jul 7, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Sep 1, 2017 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients

Locations

93 Manalapan Ave
Freehold, NJ 07728
Phone (732) 303-8800

20 Prospect Ave
Hackensack, NJ 07601
Phone (201) 996-2816

20 Prospect Ave
Ste 410
Hackensack, NJ 07601
Phone (551) 996-4070

5 Summit Ave
Ste 105
Hackensack, NJ 07601
Phone (201) 996-2900

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

100 Mazdabrook Rd
#One
Parsippany, NJ 07054
Phone (732) 841-9338

3626 US Highway 1
Princeton, NJ 08540
Phone (609) 243-0445

Interoperability endpoints

  • Direct secure messaging: shannon.byrne@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499385600000",
    "number": "1033631460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10-05 BACKUS RD",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074101925",
            "telephone_number": "201-956-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE STE 410",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011941",
            "telephone_number": "551-996-4070",
            "fax_number": "551-996-4072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRNE",
        "first_name": "SHANNON",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "APN, NP-C, CWOCN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2017-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00742100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.