Individual provider Active NPI

Shannon Marie Ferriter

  • Counselor
  • Rockford, IL
National Provider Identifier
1417435652
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
8616 Northern Ave
Rockford, IL 61107-5309
Phone
(815) 332-8003
NPI assigned
Jul 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

8616 Northern Ave
Rockford, IL 61107-5309

Mailing address

1021 N Mulford Rd
Rockford, IL 61107-3877
Phone (815) 387-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210129000305 IL Practitioner - Clinical Social Worker 5496169666 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rockford Psychiatric Medical Services SCGroup PAC ID 6901089515, 154 clinicians

Practice addresses (Care Compare)

1639 N Alpine Rd
Suite 500
Rockford, IL 61107-1440
Phone (815) 395-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Psychiatric Medical Services, S.C. CurrentSince Oct 20, 2021 Accepting new patients
Rosecrance Inc CurrentSince Jan 1, 2021 Accepting new patients
Rosecrance Inc Current Accepting new patients
Rosecrance Inc CurrentSince Jan 1, 2021 Accepting new patients

Locations

915 Alexandra Dr
Belvidere, IL 61008
Phone (815) 544-4849

1601 University Dr
Rockford, IL 61107
Phone (815) 387-2500

1021 N Mulford Rd
Rockford, IL 61107
Phone (815) 387-5600

1639 N Alpine Rd
Ste 260
Rockford, IL 61107
Phone (815) 395-1500

1639 N Alpine Rd
Ste 500
Rockford, IL 61107
Phone (815) 395-1500

8616 Northern Ave
Rockford, IL 61107
Phone (815) 332-8003

Interoperability endpoints

  • Direct secure messaging: shannon.ferriter.1@25899.direct.athenahealth.com

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": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1417435652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073877",
            "telephone_number": "815-387-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8616 NORTHERN AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075309",
            "telephone_number": "815-332-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRITER",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.