Shannon Lee Rakitis, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP032917 Issued in PA

Practice address

3400 Civic Center Blvd
Philadelphia, PA 19104-5127

Phone

(215) 662-3487

NPI assigned

Jun 11, 2025

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 PA, NJ2 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, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CGJGAD

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.

• Philadelphia Family Medicne Assoc P.C.

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1912958638
  Medicare reassignment NPD
• Kennedy Medical Group Practice, P.C.

  • Family Medicine Physician
  • Voorhees, NJ
  • NPI 1952726796
  Medicare reassignment NPD
• Kennedy Medical Group Practice PC

  • Family Medicine Physician
  • Sewell, NJ
  • NPI 1952848905
  NPD
• Kennedy Medical Group Practice P.C.

  • Family Medicine Physician
  • West Deptford, NJ
  • NPI 1952615981
  NPD (past)

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

• Kennedy University Hospital Inc.

  • General Acute Care Hospital
  • Stratford, NJ
  • NPI 1386746592
  Care Compare affiliation

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

{
    "created_epoch": "1749600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1508751264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 KESWICK DR",
            "city": "WOOLWICH TOWNSHIP",
            "state": "NJ",
            "postal_code": "080852541",
            "telephone_number": "856-693-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-662-3487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKITIS",
        "first_name": "SHANNON",
        "middle_name": "LEE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-11",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP032917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Birgit Rakel, M.D.
• Krista Grace Rakickas
• Tara Rakiewicz, MD
• Peter Rakita, MD
• Val Rakita, M.D.
• Chrystyna Rakoczy, OD
• Chelsea Rakszawski
• Rochelle Bettyjean Raleigh, PHD
• Parth M Rali, MD
• Gavin Rallis

• Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.