Shannon Marie Nicosia, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP025407 Issued in PA

Practice address

200 Scenery Dr
State College, PA 16801-7974

Phone

(570) 271-6516

NPI assigned

Aug 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.nicosia@489656322949124.direct.elationemr.com

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.

• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868

  Nurse Practitioner

  Medicare reassignment NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Selinsgrove, PA
  • NPI 1508292715

  Nurse Practitioner

  NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD
• FLH Medical, PC

  • Gastroenterology Physician
  • Geneva, NY
  • NPI 1164766325
  NPD
• FLH Medical, PC

  • Family Medicine Physician
  • Penn Yan, NY
  • NPI 1215174644
  NPD
• Soldiers & Sailors Memorial Hospital

  • Critical Access Hospital
  • Penn Yan, NY
  • NPI 1215044516
  NPD
• University Ambulance Service

  • Land Ambulance
  • University Park, PA
  • NPI 1255457057
  NPD (past)

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1114539269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 HARVEST HILL LN",
            "city": "SPRING MILLS",
            "state": "PA",
            "postal_code": "168751610",
            "telephone_number": "814-360-8827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SCENERY DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017974",
            "telephone_number": "570-271-6516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Academy Ave",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "PA",
            "postal_code": "178229764",
            "country_code": "US",
            "telephone_number": "570-271-6516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICOSIA",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "346354",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP025407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha L Nguyen, MD
• Thuy-Van Nguyen, DDS
• Jeffrey M Nicastro, D.C.
• Leslie Nicholls
• Rudy J Nicolas, M.D.
• Kathryn Sherril Nieman, PT
• Tedd P Niemi
• Nittany Anesthesia PC
• Nittany Dental, Inc.
• Nittany Eye Associates LTD

• Nurse Practitioner in State College, PA
• Providers in State College, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.