Individual provider Active NPI

Shannon Connor Junior, CRNA, APN

  • Certified Registered Nurse Anesthetist
  • Camden, NJ
National Provider Identifier
1114680709
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NJ01217800 Issued in NJ
Practice address
1600 Haddon Ave
Camden, NJ 08103-3101
Phone
(856) 755-1616
Fax
(856) 755-0098
NPI assigned
Oct 20, 2021
Last updated
Oct 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 26NJ01217800 NJ Primary

Addresses

Primary practice location

1600 Haddon Ave
Camden, NJ 08103-3101

Mailing address

658 N Saratoga Dr
Moorestown, NJ 08057-3834
Phone (856) 313-3798

Other names 1

  • Miss Shannon Connor Junior Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211217001416 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668863135 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Jersey Healthcare Specialists PCGroup PAC ID 2668385253, 570 clinicians

Practice addresses (Care Compare)

1 Bay Ave
Montclair, NJ 07042-4837
Phone (973) 429-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NJ01217800NJMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Healthcare Specialists PC CurrentSince May 1, 2024 Accepting new patients
Mid-Atlantic Anesthesia Associates PA CurrentSince Nov 15, 2021 Accepting new patients
North American Partners in Anesthesia of New Jersey LLC CurrentSince Mar 29, 2022 Accepting new patients
Rwjbh Observation Associates LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

1600 Haddon Ave
Camden, NJ 08103
Phone (609) 757-3500

1600 Haddon Ave
#L
Camden, NJ 08103
Phone (856) 757-3500

901 W Main St
Freehold, NJ 07728
Phone (732) 294-2666

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Organizations & group practices 4

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 1

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": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1114680709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 N SARATOGA DR",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573834",
            "telephone_number": "856-313-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HADDON AVE",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081033101",
            "telephone_number": "856-755-1616",
            "fax_number": "856-755-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNIOR",
        "first_name": "SHANNON",
        "middle_name": "CONNOR",
        "name_prefix": "Miss",
        "credential": "CRNA, APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ01217800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "JUNIOR",
            "middle_name": "CONNOR",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.