Individual provider Active NPI

Shannon Telis Merwin, FNP-BC

  • Family Nurse Practitioner
  • Raeford, NC
National Provider Identifier
1043918055
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5017680 Issued in NC
Practice address
929 W Prospect Rd
Raeford, NC 28376-9543
Phone
(910) 904-1695
Fax
(910) 904-1767
NPI assigned
Feb 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5017680 NC Primary

Addresses

Primary practice location

929 W Prospect Rd
Raeford, NC 28376-9543

Mailing address

929 W Prospect Rd
Raeford, NC 28376-9543
Phone (910) 904-1695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230421000466 NC Practitioner - Nurse Practitioner 5395100671 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FHPG LLCGroup PAC ID 9537481569, 195 clinicians

Practice addresses (Care Compare)

1690 US Hwy 1 S
Suite 200
Southern Pines, NC 28387-7037
Phone (910) 684-5159

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Karen L Smith MD, PA CurrentSince Feb 15, 2023 Accepting new patients

Locations

929 W Prospect Rd
Raeford, NC 28376
Phone (910) 904-1695

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/411/brand/1/csg/1/fhir/r4
  • Direct secure messaging: shannon.merwin.1@411.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1043918055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 W PROSPECT RD",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283769543",
            "telephone_number": "910-904-1695",
            "fax_number": "910-904-1767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 W PROSPECT RD",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283769543",
            "telephone_number": "910-904-1695",
            "fax_number": "910-904-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERWIN",
        "first_name": "SHANNON",
        "middle_name": "TELIS",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5017680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raeford, NC

Sources for this page

Verify at the official NPI Registry.