Individual provider Active NPI

Shannon B Kiry, SW

  • Social Worker
  • Philadelphia, PA
National Provider Identifier
1437315090
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW126791 Issued in PA
Practice address
3975 Conshohocken Ave
Philadelphia, PA 19131-5426
Phone
(215) 879-1000
Fax
(215) 879-3912
NPI assigned
Aug 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW126791 PA Primary

Addresses

Primary practice location

3975 Conshohocken Ave
Philadelphia, PA 19131-5426

Mailing address

101 Acadia Dr
Cinnaminson, NJ 08077-3136
Phone (215) 879-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW126791PAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217808000000",
    "number": "1437315090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 ACADIA DR",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080773136",
            "telephone_number": "215-879-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 CONSHOHOCKEN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191315426",
            "telephone_number": "215-879-1000",
            "fax_number": "215-879-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRY",
        "first_name": "SHANNON",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "SW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2008-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW126791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.