Shanniqua Mitchell, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

357874 Issued in NY

Practice address

94 Benson St
West Haverstraw, NY 10993-1303

Phone

(845) 274-0070

NPI assigned

Mar 20, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1528562105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 BENSON ST",
            "city": "WEST HAVERSTRAW",
            "state": "NY",
            "postal_code": "109931303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 BENSON ST",
            "city": "WEST HAVERSTRAW",
            "state": "NY",
            "postal_code": "109931303",
            "telephone_number": "845-274-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SHANNIQUA",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "357874",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "627210",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "627210",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peg Meisler, P.T., C.C.S.
• Philip Melchiorre, MD
• Abby Miller, OTR
• David G Miller, OTR, ATP
• Regina C Mitchell
• Lisa Modell
• Nadia Moger, SLP
• David F Moretto, CP
• Tararoz Morin
• Christine Ann Mulholland

• Family Nurse Practitioner in West Haverstraw, NY
• Providers in West Haverstraw, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.