Shannon Louette Skaug, CRNP
Individual provider Active NPI Nurse Practitioner · Pinehurst, NC
NPI 1255825832 · NPPES record last updated Oct 18, 2022
Key facts
- NPI
- 1255825832
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 1-153334 (AL)
- Practice address
- 5 First Village Dr
Pinehurst, NC 28374-9495 - Phone
- (910) 235-2709
- Fax
- (910) 215-3080
- NPI assigned
- Jun 18, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- FHPG LLC
Practice addresses (Care Compare)
6408 Fayetteville Rd
Raeford, NC 28376-7977
Phone (910) 878-6000
Hospital & facility affiliations
- First Health Home Care - Richmond
- Firsthealth Moore Regional Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AL, NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180827003525 | AL | Practitioner - Nurse Practitioner | 0840549663 | Reassigns benefits to 1 organization |
| I20200806002050 | NC | Practitioner - Nurse Practitioner | 0840549663 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-153334 | AL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FHPG, LLC | Current |
Accepting new patients | |
| Pinehurst Surgical Clinic PA | Current |
Accepting new patients | |
| FHPG, LLC | Current |
Accepting new patients | |
| MCPC-9, LLC | Current |
Accepting new patients | |
| Houston County Healthcare Authority | Current | Accepting new patients | |
| Houston County Healthcare Authority | Current | Accepting new patients | |
| Medcore Associates, PLLC | Current | Accepting new patients | |
| Houston County Healthcare Authority | Nurse Practitioner | Current |
Accepting new patients |
| Pathology Laboratory Associates | Current | Accepting new patients | |
| FHPG, LLC | Current | Accepting new patients | |
| FHPG, LLC | Past | Accepting new patients |
Locations
1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635
1118 Ross Clark Cir
Ste 200
Dothan, AL 36301
Phone (334) 793-4804
5 First Village Dr
Pinehurst, NC 28374
Phone (910) 235-2713
46 Memorial Dr
Pinehurst, NC 28374
Phone (910) 295-6782
155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000
6408 Fayetteville Rd
Raeford, NC 28376
Phone (910) 878-6000
809 S Long Dr
Ste K
Rockingham, NC 28379
Phone (910) 417-4090
925 S Long Dr
Rockingham, NC 28379
Phone (910) 417-3000
520 Allen St
Troy, NC 27371
Phone (910) 571-5000
Interoperability endpoints
- sskaug101209@firsthealth.direct-ci.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5013285 | NC | |
| Nurse Practitioner | 363L00000X | 1-153334 | AL | Yes |
Addresses
Primary practice location
5 First Village Dr
Pinehurst, NC 28374-9495
Mailing address
PO Box 2000
Pinehurst, NC 28374-2000
Phone (910) 235-2709
Other providers in Pinehurst, NC
- Misty L Sinclair
- Noelani Joy Sinclair
- Pallavi Sindhu
- Cassandra Singleton-Shokunbi
- Kenya Singley
- Scott D Skibo
- Joseph M Skladany
- Zoila Dana Slappe
- Kevin Thomas Slater
- Van Slaughter Jr.
All providers in Pinehurst, NC · Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.