NPIMap

Individual provider Active NPI

Shannon Marie Mooney, CNP

  • Gerontology Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1508397290
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
CNP 5045 Issued in MN
Practice address
45 10TH St W
Saint Paul, MN 55102-1062
Phone
(651) 326-3800
NPI assigned
Mar 23, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Curana Health of Minnesota PLLC 62 clinicians
Lifespark Medical Group PA 19 clinicians

Practice addresses (Care Compare)

5123 W 98TH St
Suite 2082
Minneapolis, MN 55437-2040
Phone (737) 226-6700

5320 W 23Rd St
Suite 130
St Louis Park, MN 55416-1670
Phone (952) 345-3213

Hospital & facility affiliations

  • Lifespark Home Health Home health agency, Saint Louis Park, MN, CCN 248118
  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057

Merit-based Incentive Payment System (MIPS)

Final score
87.25 of 100Reported as group
Quality
60.43
Promoting interoperability
83
Improvement activities
40
Cost
79.28

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170608001939 MN Practitioner - Nurse Practitioner 3173891454 Reassigns benefits to 7 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP 5045MNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care CurrentSince Oct 15, 2020 Accepting new patients
Fairview Clinics CurrentSince Oct 15, 2020 Accepting new patients
Fairview Health Services Current Accepting new patients
Curana Health of Minnesota PLLC CurrentSince Jan 1, 2026 Accepting new patients
Fairview Express Care CurrentSince Oct 15, 2020 Accepting new patients
Lifespark Medical Group, PA Gerontology CurrentSince Jan 3, 2022 Accepting new patients
Healtheast Medical Research Institute CurrentSince Oct 15, 2019 Accepting new patients
Fairview Health Services CurrentSince Oct 15, 2020 Accepting new patients
Healtheast Medical Research Institute CurrentSince Oct 15, 2019 Accepting new patients
Spark Medical Providers PA CurrentSince Oct 2, 2025 Accepting new patients
CH Specialty Services MN PC CurrentSince Jan 1, 2026 Accepting new patients

Locations

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

5123 W 98th St
Minneapolis, MN 55437
Phone (312) 961-4490

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

69 Exchange St W
Saint Paul, MN 55102
Phone (651) 232-1100

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

5320 W 23rd St
Ste 130
St Louis Park, MN 55416
Phone (952) 345-3213

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: shannon.mooney.1@15699.direct.athenahealth.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: shannon.mooney.1@17901.direct.athenahealth.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X CNP 5045 MN Primary

Addresses

NPPES NPI Registry

Primary practice location

45 10TH St W
Saint Paul, MN 55102-1062

Mailing address

396 Linda Ave
Lino Lakes, MN 55014-6404
Phone (612) 770-4296

Other practice location 1

3433 Broadway St NE Ste 300
Minneapolis, MN 55413-1761
Phone (763) 587-7737

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 16, 2019.

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1508397290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 LINDA AVE",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550146404",
            "telephone_number": "612-770-4296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 10TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021062",
            "telephone_number": "651-326-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3433 Broadway St NE Ste 300",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554131761",
            "country_code": "US",
            "telephone_number": "763-587-7737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "CNP 5045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.