Individual provider Active NPI

Cindy Shannon, RN, CPNP

  • Pediatric Nurse Practitioner
  • Greenbelt, MD
National Provider Identifier
1154685808
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R172234 Issued in MD
Practice address
7401 Greenbelt Rd
Greenbelt, MD 20770-3402
Phone
(301) 982-5428
NPI assigned
Jun 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN1004656 DC
Pediatric Nurse Practitioner 363LP0200X R172234 MD Primary

Addresses

Primary practice location

7401 Greenbelt Rd
Greenbelt, MD 20770-3402

Mailing address

PO Box 37215
Baltimore, MD 21297-7215
Phone (202) 302-8816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150402001373 DC Practitioner - Nurse Practitioner 7911150594 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R172234MDMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital CurrentSince Sep 18, 2012 Accepting new patients
Children'S Hospital CurrentSince Sep 18, 2012 Accepting new patients
Children'S Hospital Current Accepting new patients
Commonwealth Emergency Physicians PC PastSince Apr 17, 2020 Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

Interoperability endpoints

  • Direct secure messaging: cindy.shannon@pmuc.eclinicaldirectplus.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1154685808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37215",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212977215",
            "telephone_number": "202-302-8816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 GREENBELT RD",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703402",
            "telephone_number": "301-982-5428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "CINDY",
        "credential": "RN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2021-09-07",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "DC",
            "license": "RN1004656",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R172234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbelt, MD

Sources for this page

Verify at the official NPI Registry.