NPIMap

Individual provider Active NPI

Shannon Cathleen Kelly, APN

  • Acute Care Nurse Practitioner
  • Toms River, NJ
National Provider Identifier
1093469744
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NR01268700 Issued in NJ
Practice address
601 Route 37 W Ste 104
Toms River, NJ 08755-8050
Phone
(732) 240-1100
NPI assigned
Feb 10, 2022
Last updated
Feb 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 26NR01268700 NJ Primary

Addresses

Primary practice location

601 Route 37 W Ste 104
Toms River, NJ 08755-8050

Mailing address

601 Rte 37 W Ste 104
Toms River, NJ 08755-8050
Phone (732) 240-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220407000023 NJ Practitioner - Nurse Practitioner 2567858111 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Change of Heart Cardiology LLCGroup PAC ID 1658467956, 4 clinicians

Practice addresses (Care Compare)

2130 Hwy 35
Suite 321C
Sea Girt, NJ 08750-1011
Phone (732) 974-6700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.85 of 100Reported as group
Quality
86.16
Improvement activities
40
Cost
81.27

Merit-based Incentive Payment System (MIPS)

Final score
95.79 of 100Reported as group
Quality
98.99
Improvement activities
40
Cost
70.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR01268700NJMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Physicians LLC CurrentSince Mar 18, 2022 Accepting new patients
Change of Heart Cardiology, LLC CurrentSince Jan 13, 2024 Accepting new patients
Ocean Primary Care LLC CurrentSince Apr 26, 2022 Accepting new patients

Locations

2130 Highway 35
Ste 321
Sea Girt, NJ 08750
Phone (732) 974-6700

2130 Highway 35
Ste 321C
Sea Girt, NJ 08750

2130 Highway 35
Ste 325
Sea Girt, NJ 08750

2130 Highway 35
Ste 325C
Sea Girt, NJ 08750

601 Route 37 W
Ste 104
Toms River, NJ 08755
Phone (732) 240-1100

Interoperability endpoints

  • Direct secure messaging: shannon.kelly@changeofheartcardiology.chartmakerdirect.com
  • Direct secure messaging: skelly@chc.azalea.phimailbox.com

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.

Hospital & facility affiliations 6

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": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1093469744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 RTE 37 W STE 104",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087558050",
            "telephone_number": "732-240-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ROUTE 37 W STE 104",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087558050",
            "telephone_number": "732-240-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SHANNON",
        "middle_name": "CATHLEEN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NR01268700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

Verify at the official NPI Registry.