Shannon Nicole Martin, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R182264 Issued in MD

Practice address

1406B Crain Hwy S Ste 304
Glen Burnie, MD 21061-4094

Phone

(301) 804-0344

NPI assigned

Dec 9, 2015

Last updated

Dec 19, 2022By 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 DC, MD2 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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smartin@healthreleaf.kareodirect.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.

• Health Releaf LLC

  • Primary Care Clinic/Center
  • Glen Burnie, MD
  • NPI 1235616475

  DC

  Medicare reassignment NPD Authorized official
• Authentic Release Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Glen Burnie, MD
  • NPI 1720869548
  Authorized official Same address or phone
• New Changes LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Glen Burnie, MD
  • NPI 1063354124
  NPD (past) Authorized official
• New Changes LLC

  • Family Nurse Practitioner
  • Glen Burnie, MD
  • NPI 1508708652
  NPD (past) Authorized official
• Health Releaf LLC

  dba Self

  • Psychiatric/Mental Health Nurse Practitioner
  • Glen Burnie, MD
  • NPI 1770255291
  NPD (past)

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1417322926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406B CRAIN HWY S STE 304",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614094",
            "telephone_number": "301-804-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406B CRAIN HWY S STE 304",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614094",
            "telephone_number": "301-804-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-09",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R182264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey D Marshall, M.D., MPH, MS
• Vida Martey, PMHNP
• Alyson Martin
• Bria Martin
• Erin Martin, LCMFT
• Maryland CVS Pharmacy LLC (CVS Pharmacy # 05706)
• Maryland CVS Pharmacy LLC (CVS Pharmacy #16392)
• Maryland CVS Pharmacy LLC (CVS Pharmacy #17055)
• Maryland CVS Pharmacy, L.L.C. (CVS Pharmacy #01735)
• Maryland Family Care, Inc.

• Family Nurse Practitioner in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.