NPIMap

Organization Active NPI

Shannondell, Inc.

  • Primary Care Clinic/Center
  • Audubon, PA
National Provider Identifier
1225825342
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SHANNONDELL, INC.
Practice address
20000 Shannondell Dr
Audubon, PA 19403-5653
Phone
(610) 382-9737
NPI assigned
Apr 22, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Authorized official

Name
Mr. David Rittenhouse
Title
President/Owner
Phone
(610) 999-3560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

20000 Shannondell Dr
Audubon, PA 19403-5653

Mailing address

5000 Shannondell Dr
Audubon, PA 19403-5684
Phone (610) 728-5400

Other names 1

  • Shannondell Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130627000670 PA Part B Supplier - Clinic/Group Practice 9032141189 Receives reassigned benefits from 22 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Audubon, PA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2327598Shannondell Medical Group20000 Shannondell Drive, Audubon, PA 19403Certificate of waiverJul 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Shannondell Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6000 Shannondell Dr
Norristown, PA 19403
Phone (610) 382-8710

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1225825342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 SHANNONDELL DR",
            "city": "AUDUBON",
            "state": "PA",
            "postal_code": "194035684",
            "telephone_number": "610-728-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20000 SHANNONDELL DR",
            "city": "AUDUBON",
            "state": "PA",
            "postal_code": "194035653",
            "telephone_number": "610-382-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNONDELL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-22",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "RITTENHOUSE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "610-999-3560",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shannondell Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Audubon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.