Individual provider Active NPI

Shannon Bridget Fitzgerald, CRNP

  • Family Nurse Practitioner
  • Allison Park, PA
National Provider Identifier
1356717607
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP015217 Issued in PA
Practice address
4849 William Flynn Hwy
Allison Park, PA 15101-2319
Phone
(724) 443-2418
NPI assigned
Aug 20, 2015
Last updated
Jun 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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 SP015217 PA Primary

Addresses

Primary practice location

4849 William Flynn Hwy
Allison Park, PA 15101-2319

Mailing address

4849 William Flynn Hwy
Allison Park, PA 15101-2319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150922000484 PA Practitioner - Nurse Practitioner 2062729189 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP015217PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Opioid Addiction Recovery Services CurrentSince Sep 2, 2023 Accepting new patients
Tranquil Minds Addiction and Psychiatry Current Accepting new patients
Balanced Health Care Solutions, P.C. PastSince Sep 2, 2023 Accepting new patients

Locations

2360 Hospital Dr
Lowr
Aliquippa, PA 15001
Phone (724) 912-6277

200 S McKean St
Butler, PA 16001
Phone (724) 912-6277

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1356717607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4849 WILLIAM FLYNN HWY",
            "city": "ALLISON PARK",
            "state": "PA",
            "postal_code": "151012319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 WILLIAM FLYNN HWY",
            "city": "ALLISON PARK",
            "state": "PA",
            "postal_code": "151012319",
            "telephone_number": "724-443-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "SHANNON",
        "middle_name": "BRIDGET",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-20",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP015217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allison Park, PA

Sources for this page

Verify at the official NPI Registry.