Individual provider Active NPI

Shannon Craig, CRNP

  • Family Nurse Practitioner
  • Ellicott City, MD
National Provider Identifier
1306183520
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R169027 Issued in MD
Practice address
3300 Centennial LN
Ellicott City, MD 21042-3600
Phone
(866) 389-2727
NPI assigned
Jan 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R169027 MD Primary

Addresses

Primary practice location

3300 Centennial LN
Ellicott City, MD 21042-3600

Mailing address

3300 Centennial LN
Ellicott City, MD 21042-3600
Phone (866) 389-2727

Other practice location 1

19731 Germantown Rd
Germantown, MD 20874-1221
Phone (301) 693-8860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20190313002329 MD Practitioner - Nurse Practitioner 3072853860 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Menocal Medical Services PA Current Accepting new patients
Privia Care Center LLC Current Accepting new patients
Privia Care Center LLC CurrentSince Nov 16, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

110 Baughmans Ln
Ste 140
Frederick, MD 21702
Phone (240) 215-1138

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Organizations & group practices 4

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": "1357603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1306183520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 CENTENNIAL LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423600",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 CENTENNIAL LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423600",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19731 Germantown Rd",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "MD",
            "postal_code": "208741221",
            "country_code": "US",
            "telephone_number": "301-693-8860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "SHANNON",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-08",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R169027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.