Shannon Nicole O'Brien, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA058204 Issued in PA

Practice address

640 Alden St
Meadville, PA 16335-2348

Phone

(814) 373-5255

Fax

(814) 373-5259

NPI assigned

Aug 20, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Shannon Nicole Wanichko Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians

Titusville Area HospitalGroup PAC ID 8022907575, 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vna Alliance Home health agency, Meadville, PA, CCN 397655
• Meadville Medical Center Hospital, Meadville, PA, CCN 390113
• Titusville Area Hospital Hospital, Titusville, PA, CCN 391314

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Titusville Area Hospital

  • Rural Health Clinic/Center
  • Meadville, PA
  • NPI 1962964981
  Medicare reassignment Care Compare group NPD (past)
• Titusville Area Hospital

  • Rural Health Clinic/Center
  • Conneaut Lake, PA
  • NPI 1053873976
  NPD
• Titusville Area Hospital

  • Audiologist
  • Titusville, PA
  • NPI 1306712104
  NPD
• Titusville Area Hospital

  • Rural Health Clinic/Center
  • Conneautville, PA
  • NPI 1235691973
  NPD (past)
• Titusville Area Hospital

  • Rural Health Clinic/Center
  • Oil City, PA
  • NPI 1760976336
  NPD (past)

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

• Alliance Visiting Nurses

  • Home Health Agency
  • Meadville, PA
  • NPI 1932167921
  Care Compare affiliation
• Meadville Medical Center

  • General Acute Care Hospital
  • Meadville, PA
  • NPI 1942276423
  Care Compare affiliation
• Titusville Area Hospital

  • Critical Access Hospital
  • Titusville, PA
  • NPI 1891899332
  Care Compare affiliation

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1053744425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 GROVE STREET",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352945",
            "telephone_number": "814-373-3530",
            "fax_number": "814-333-1757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 ALDEN ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352348",
            "telephone_number": "814-373-5255",
            "fax_number": "814-373-5259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA003787",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085004752",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA058204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "WANICHKO",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Northwest Physicians Associates, P.C.
• Anand Noticewala
• Novacare Outpatient Rehabilitation East, Inc.
• Cynthia D Novotny, PA-C
• Pamela K O' Laughlin
• Erin Michelle O'Dell, PHARMD
• Michael O'Malley, M.D.
• Ryan O'Sullivan, CRNA
• Oakes Chiropractic
• Mark W Oakes, DC

• Medical Physician Assistant in Meadville, PA
• Providers in Meadville, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.