Individual provider Active NPI

Wendy Lorraine Shannon, FNP-C

  • Nurse Practitioner
  • Fishers, IN
National Provider Identifier
1497868186
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71000333A Issued in IN
Practice address
8300 E 96TH St
Fishers, IN 46037-9795
Phone
(317) 621-1290
Fax
(317) 621-1291
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71000333A IN Primary

Addresses

Primary practice location

8300 E 96TH St
Fishers, IN 46037-9795

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2805

Other identifiers 1

IdentifierTypeStateIssuer
200190000MedicaidIN

Other names 1

  • Mrs. Wendy Lorraine Shannon-Harden Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wshannon10569@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100917000366 IN Practitioner - Nurse Practitioner 8820113558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

3125 S Scatterfield Rd
Anderson, IN 46013-1804

7120 Clearvista Dr
Suite 4000
Indianapolis, IN 46256-1774
Phone (317) 621-7444

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71000333AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
His Solutions Specialty Care Corp. CurrentSince Mar 25, 2019 Accepting new patients
Union Healthcare Services Inc CurrentSince Feb 9, 2020 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Sep 28, 2011 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Sep 28, 2011 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1030 S Scatterfield Rd
Anderson, IN 46012
Phone (765) 644-5025

11911 N Meridian St
Ste 150
Carmel, IN 46032
Phone (317) 621-6700

8300 E 96th St
Fishers, IN 46037
Phone (317) 578-4416

1664 W Smith Valley Rd
Greenwood, IN 46142
Phone (317) 887-7640

1703 N Post Rd
Indianapolis, IN 46219
Phone (317) 355-3200

8177 Clearvista Pkwy
Indianapolis, IN 46256
Phone (317) 621-7800

6201 La Pas Trl
Ste 265
Indianapolis, IN 46268
Phone (317) 297-0307

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

16865 Clover Rd
Noblesville, IN 46060
Phone (317) 621-1288

9669 E 146th St
Ste 100
Noblesville, IN 46060
Phone (317) 621-3434

Interoperability endpoints

  • Direct secure messaging: wshannon10569@ecommunitydirect.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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1497868186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 E 96TH ST",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379795",
            "telephone_number": "317-621-1290",
            "fax_number": "317-621-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "WENDY",
        "middle_name": "LORRAINE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71000333A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200190000",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wshannon10569@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "8300 E 96th St",
            "city": "Fishers",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460379795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "SHANNON-HARDEN",
            "middle_name": "LORRAINE",
            "prefix": "MRS.",
            "credential": "FNP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fishers, IN

Sources for this page

Verify at the official NPI Registry.