Individual provider Active NPI

Shannon Irish

  • Family Nurse Practitioner
  • Maysville, KY
National Provider Identifier
1407697709
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4021528 Issued in KY
Practice address
4245 Pleasant Ridge Rd
Maysville, KY 41056-8601
Phone
(606) 584-1224
NPI assigned
Jun 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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 4021528 KY Primary

Addresses

Primary practice location

4245 Pleasant Ridge Rd
Maysville, KY 41056-8601

Mailing address

4245 Pleasant Ridge Rd
Maysville, KY 41056-8601
Phone (606) 584-1224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240913001884 KY Practitioner - Nurse Practitioner 7214477439 Reassigns benefits to 2 organizations
I20240913002035 OH Practitioner - Nurse Practitioner 7214477439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Consonant Healing Associates of de LLCGroup PAC ID 2466871694, 81 clinicians

Practice addresses (Care Compare)

200 Public SQ
Suite 2300
Cleveland, OH 44114-2309
Phone 44338393001055

2100 Millvale Rd
Louisville, KY 40205-1604
Phone (443) 383-9300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4021528KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Consonant Healing Associates of de LLC CurrentSince Jul 1, 2024 Accepting new patients
Healing Partners Plus PLLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

828 Lane Allen Rd
Ste 219
Lexington, KY 40504

3499 Blazer Pkwy
Ste 300
Lexington, KY 40509
Phone (859) 699-1803

2100 Cherokee Ridge Way
Louisville, KY 40205
Phone (502) 451-0990

909 Ridgebrook Rd
Ste 300
Sparks Glencoe, MD 21152
Phone (443) 483-9300

200 Public Sq
Ste 2300
Cleveland, OH 44114
Phone (443) 483-9300

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1407697709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4245 PLEASANT RIDGE RD",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410568601",
            "telephone_number": "606-584-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 PLEASANT RIDGE RD",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410568601",
            "telephone_number": "606-584-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRISH",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4021528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maysville, KY

Sources for this page

Verify at the official NPI Registry.