Individual provider Active NPI

Shannon Marie Brown, DNP

  • Acute Care Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1053652289
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP4920 Issued in AZ
Practice address
250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone
(602) 445-0751
Fax
(602) 424-8128
NPI assigned
Mar 13, 2013
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP4920 AZ Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP4920 AZ

Addresses

Primary practice location

250 E Dunlap Ave
Phoenix, AZ 85020-2825

Mailing address

9225 N 3Rd St
Suite 300
Phoenix, AZ 85020-2439
Phone (602) 445-0751

Other practice location 1

9225 N 3rd St
Suite 300
Phoenix, AZ 85020-2439
Phone (602) 445-0751

Other practice location 2

21639 N 12th Ave Ste 104
Phoenix, AZ 85027-2802
Phone (602) 647-8249

Other identifiers 2

IdentifierTypeStateIssuer
822748MedicaidAZ
AP4920OtherAZACUTE CARE NURSE PRACTITIONER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20130610000059 AZ Practitioner - Nurse Practitioner 8729226410 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP4920AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Hospitalists, PLC CurrentSince May 22, 2013 Accepting new patients
Arizona Primary Care Partners LLC CurrentSince Dec 1, 2022 Accepting new patients
North Valley Psychiatry CurrentSince Sep 1, 2024 Accepting new patients

Locations

16640 N 38th St
Phoenix, AZ 85032
Phone (602) 482-6671

21639 N 12th Ave
Ste 104
Phoenix, AZ 85027
Phone (336) 343-5776

250 E Dunlap Ave
Phoenix, AZ 85020
Phone (480) 331-6721

720 E Thunderbird Rd
Ste 3
Phoenix, AZ 85022
Phone (480) 531-1681

9225 N 3rd St
Ste 300
Phoenix, AZ 85020
Phone (602) 870-1821

16772 W Bell Rd
Ste 110619
Surprise, AZ 85374
Phone (602) 616-7047

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1053652289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9225 N 3RD ST",
            "address_2": "SUITE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202439",
            "telephone_number": "602-445-0751",
            "fax_number": "602-424-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E DUNLAP AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202825",
            "telephone_number": "602-445-0751",
            "fax_number": "602-424-8128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9225 N 3rd St",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850202439",
            "country_code": "US",
            "telephone_number": "602-445-0751",
            "fax_number": "602-424-8128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21639 N 12th Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850272802",
            "country_code": "US",
            "telephone_number": "602-647-8249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-13",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP4920",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP4920",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "822748",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUTE CARE NURSE PRACTITIONER",
            "identifier": "AP4920",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.