Active NPI
Shannon Penick Pryor, MD
- Otolaryngology Physician
- Kensington, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- D0053881
- Practice address
- 10810 Connecticut Avenue
Kensington, MD 20895-2138 - Phone
- (301) 929-7100
- Fax
- (301) 929-7114
- NPI assigned
- Nov 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngic Allergy Physician | 207YX0602X | MD33647 | DC | |
| Otolaryngic Allergy Physician | 207YX0602X | 38383 | CO | |
| Otolaryngology Physician | 207Y00000X | D0053881 | MD | Primary |
| Otolaryngology Physician | 207Y00000X | 0101241142 | VA |
Addresses
Primary practice location
10810 Connecticut Avenue
Kensington, MD 20895-2138
Mailing address
2101 E Jefferson St
Kaiser Permanente Medicare Enrollment Unit
Rockville, MD 20852-4908
Phone (301) 816-6660
Other names 1
- Shannon Penick
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Tulane University School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3800 Reservoir Rd NW
Washington, DC 20007-2113
Phone (202) 444-2000
Hospital & facility affiliations
- Medstar Georgetown University Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.97 of 100
- Quality
- 72.87
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 67.82
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0053881 | MD | MD | Otolaryngology Physician |
| 0101241142 | VA | MD | Otolaryngology Physician |
| 38383 | CO | MD | Otolaryngic Allergy Physician |
| MD33647 | DC | MD | Otolaryngic Allergy Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medstar Medical Group II LLC | Current | Accepting new patients | |
| Medstar Medical Group II LLC | Current | Accepting new patients | |
| Medstar Medical Group II LLC | Current | Accepting new patients | |
| MGMC, LLC | Current | Accepting new patients | |
| Medstar Medical Group II LLC | Past | Accepting new patients |
Locations
1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401
3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203
1133 21st St NW
Fl 5
Washington, DC 20036
Phone (202) 416-2000
3800 Reservoir Rd NW
Bldg 1
Washington, DC 20007
Phone (202) 444-0924
6862 Elm St
Ste 800B
Mc Lean, VA 22101
Phone (202) 944-5301
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.
-
- General Practice Physician
- Washington, DC
- NPI 1891797148
-
- General Practice Physician
- Brandywine, MD
- NPI 1285064550
-
- General Practice Physician
- White Plains, MD
- NPI 1407559081
-
- Internal Medicine Physician
- Washington, DC
- NPI 1376887844
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Washington, DC
- NPI 1427145176
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321401600000",
"number": "1164598348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 E JEFFERSON ST",
"address_2": "KAISER PERMANENTE MEDICARE ENROLLMENT UNIT",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208524908",
"telephone_number": "301-816-6660",
"fax_number": "301-816-6308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10810 CONNECTICUT AVENUE",
"city": "KENSINGTON",
"state": "MD",
"postal_code": "208952138",
"telephone_number": "301-929-7100",
"fax_number": "301-929-7114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRYOR",
"first_name": "SHANNON",
"middle_name": "PENICK",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-28",
"last_updated": "2011-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "207YX0602X",
"taxonomy_group": "",
"desc": "Otolaryngology, Otolaryngic Allergy",
"state": "DC",
"license": "MD33647",
"primary": false
},
{
"code": "207YX0602X",
"taxonomy_group": "",
"desc": "Otolaryngology, Otolaryngic Allergy",
"state": "CO",
"license": "38383",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "MD",
"license": "D0053881",
"primary": true
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "VA",
"license": "0101241142",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHANNON",
"last_name": "PENICK",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Kensington, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; 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.
- 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.