Shannon Kelso, DNP, CRNP-PMH, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R207920 Issued in MD

Practice address

658 Kenilworth Dr Ste 206
Towson, MD 21204-2334

Phone

(443) 841-7550

NPI assigned

Jul 22, 2019

Last updated

Jan 7, 2021By 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 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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychnp Wellness Center LLCGroup PAC ID 5890919625, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19068/brand/1/csg/1/fhir/r4
• Direct secure messaging: shannon.kelso.1@19068.direct.athenahealth.com

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.

• Psychnp Wellness Center, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Towson, MD
  • NPI 1184042004
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1346893914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 KENILWORTH DR STE 206",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042334",
            "telephone_number": "443-841-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 KENILWORTH DR STE 206",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042334",
            "telephone_number": "443-841-7550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1122 Kenilworth Dr Ste 105",
            "address_purpose": "LOCATION",
            "city": "Towson",
            "state": "MD",
            "postal_code": "212042141",
            "country_code": "US",
            "telephone_number": "443-841-7785 x4521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELSO",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "DNP, CRNP-PMH, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R207920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra A Kelly, CRNA
• Gail Henri Kelly, CRNP-FAMILY
• Samuel James Kelly III, LCSW-C
• Alan Kelman, M.D.
• Ashley Kelsey, RD, LDN
• Raechelle Lynn Kempfer, NP
• Ken Zeigler, LLC (Wellspring Counseling)
• Laura Kendal, LCPC, CAC-AD
• Phillip Kendall
• Victoria Louise Kendall, BACB

• Psychiatric/Mental Health Nurse Practitioner in Towson, MD
• Providers in Towson, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.

Verify at the official NPI Registry.