NPIMap

Individual provider Active NPI

Shannon Page Hartman, C.R.N.P.

  • Nurse Practitioner
  • Hagerstown, MD
National Provider Identifier
1528089323
Registry record updated Feb 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R114691 Issued in MD
Practice address
17812 College Rd
Hagerstown, MD 21740-1709
Phone
(301) 582-0133
Fax
(301) 582-0133
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2008

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 R114691 MD Primary

Addresses

Primary practice location

17812 College Rd
Hagerstown, MD 21740-1709

Mailing address

16605 Kendle Rd
Williamsport, MD 21795-1614
Phone (301) 223-1241

Other identifiers 1

IdentifierTypeStateIssuer
824211OtherMDMAMSI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20080514000214 MD Practitioner - Nurse Practitioner 8224107420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meritus Medical Center IncGroup PAC ID 7113811795, 730 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Hagerstown, MD 21742-6700

Hospital & facility affiliations

  • Berkeley Medical Center Hospital, Martinsburg, WV, CCN 510008
  • Meritus Medical Center Hospital, Hagerstown, MD, CCN 210001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R114691MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Manzar J Shafi MD PA CurrentSince May 5, 2014 Accepting new patients
Meritus Medical Laboratory LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Transitioncare LLC Past Accepting new patients

Locations

368 Mill St
Hagerstown, MD 21740
Phone (301) 739-4510

Interoperability endpoints

  • Direct secure messaging: shannon.hartman.1@21601.direct.athenahealth.com

Organizations & group practices 12

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201996800000",
    "number": "1528089323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16605 KENDLE RD",
            "city": "WILLIAMSPORT",
            "state": "MD",
            "postal_code": "217951614",
            "telephone_number": "301-223-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17812 COLLEGE RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217401709",
            "telephone_number": "301-582-0133",
            "fax_number": "301-582-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "SHANNON",
        "middle_name": "PAGE",
        "credential": "C.R.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R114691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "824211",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.