Shannon M Kovalcik, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP2427 Issued in AZ

Practice address

4840 E Indian School Rd Ste 101
Phoenix, AZ 85018-5500

Phone

(602) 224-6174

NPI assigned

Nov 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• The Little Clinic of Arizona LLC

  • Family Nurse Practitioner
  • Buckeye, AZ
  • NPI 1023216249
  Medicare reassignment NPD
• Biltmore Family Physicians, PC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1811078843
  NPD (past)
• Mydockj

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1407129646
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245317502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24431 N 38TH TER",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853103360",
            "telephone_number": "623-399-8717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 E INDIAN SCHOOL RD STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850185500",
            "telephone_number": "602-224-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALCIK",
        "first_name": "SHANNON",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP2427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Kovac, D.C.
• Stephanie Kovach
• Angela Herro Kovacik, MD
• Daniel Kovacik, D.M.D., M.P.H
• Jennifer A Kovacik, M.D.
• Christina M Kovalik, NMD
• Melissa Kovar, DPT
• David Koven, DO
• Jacqueline Solange Kowal, OD
• James William Kowal, SLPA

• Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.