Shannon C Pitt, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Northome, MN
NPI 1093377640 · NPPES record last updated Mar 10, 2023
Key facts
- NPI
- 1093377640
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 6664 (MN)
- Practice address
- 12052 Main St.
Northome, MN 56661 - Phone
- (218) 897-5222
- NPI assigned
- Jul 3, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 21
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sanford Health of Northern Minnesota
Practice addresses (Care Compare)
1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-5000
Hospital & facility affiliations
- Sanford Bemidji Medical Center
- Sanford Bagley Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.56 of 100
- Quality
- 74.25
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.16
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- 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 |
|---|---|---|---|---|
| I20190820002245 | MN | Practitioner - Nurse Practitioner | 0941538607 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Health of Northern Minnesota | Current | Accepting new patients | |
| Sanford Health of Northern Minnesota | Current |
Accepting new patients |
Locations
1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 6664 | MN | Yes |
Addresses
Primary practice location
12052 Main St.
Northome, MN 56661
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Other practice location 1
1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-5000
Other providers in Northome, MN
- Cook Area Health Services, Inc
- Northome Healthcare Center, Inc
- Northome-Tealwood Transportation
- South Koochiching Isd 363
- Carol A Thurlby
All providers in Northome, MN · Family Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 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.