Shannon Skowron, APNP
Individual provider Active NPI Family Nurse Practitioner · Jackson, WI
NPI 1063128221 · NPPES record last updated Mar 21, 2023
Key facts
- NPI
- 1063128221
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 13219 (WI)
- Practice address
- W225 N16711 Cedar Park CT
Jackson, WI 53037-9222 - Phone
- (262) 677-1101
- NPI assigned
- Jan 30, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Froedtert Andthe Medical College of Wisconsin Community Physicians Inc
Practice addresses (Care Compare)
W180N8085 Town Hall Rd
FL 3
Menomonee Falls, WI 53051-3518
Phone (262) 251-1000
Hospital & facility affiliations
- St Josephs Community Hospital West Bend
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230329003050 | WI | Practitioner - Nurse Practitioner | 4082088224 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13219 | WI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current |
Accepting new patients | |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current |
Accepting new patients |
Locations
W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060
W225N16711 Cedar Park Ct
Jackson, WI 53037
Phone (262) 323-9257
W180N8085 Town Hall Rd
Fl 3
Menomonee Falls, WI 53051
N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744
1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990
Interoperability endpoints
- shollidayrn194135@direct.froedtert.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 13219 | WI | Yes |
Addresses
Primary practice location
W225 N16711 Cedar Park CT
Jackson, WI 53037-9222
Mailing address
W225N16711 Cedar Park CT
Jackson, WI 53037-9222
Phone (262) 677-1101
Other names
- Shannon Holliday
Other providers in Jackson, WI
- Christina Marie Rutsch
- Jessica Schaetzel
- Meghan Marie Schmitz
- Barry Schulman
- Mark Seip
- SNH SE Tenant TRS, Inc
- Linda Soulad
- Laura Jean Steinmetz
- Samuel R Stevens
- Rachel Telschow
All providers in Jackson, WI · Family Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.