Shannon Elizabeth Fah, NP
Individual provider Active NPI Family Nurse Practitioner · Long Prairie, MN
NPI 1548043144 · NPPES record last updated Nov 13, 2025
Key facts
- NPI
- 1548043144
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 10893 (MN)
- Practice address
- 50 Centracare Dr
Long Prairie, MN 56347-2100 - Phone
- (320) 732-2131
- Fax
- (320) 732-6913
- NPI assigned
- Aug 16, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Centracare Health System - Long Prairie
Practice addresses (Care Compare)
50 Centracare Dr
Long Prairie, MN 56347-2100
Phone (320) 732-2141
Hospital & facility affiliations
- Centracare Home Health
- Centracare Hospice
- Centracare - Long Prairie Hospital
- Centracare Health System - Sauk Centre
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231205000217 | MN | Practitioner - Nurse Practitioner | 3476901224 | Reassigns benefits to 7 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10893 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aim-Axness Integrative Medicine, PLLC | Current |
Accepting new patients | |
| Centracare Health System - Long Prairie | Current |
Accepting new patients | |
| Centracare Health System - Melrose | Current |
Accepting new patients | |
| Centracare Health System - Long Prairie | Current |
Accepting new patients | |
| Centracare Health System - Sauk Centre | Current | Accepting new patients | |
| Centracare Health System - Sauk Centre | Current |
Accepting new patients | |
| Axness Chiropractic PLLC | Current |
Accepting new patients | |
| Centracare Health System - Sauk Centre | Current |
Accepting new patients |
Locations
7350 Clearwater Rd
Baxter, MN 56425
Phone (218) 454-5050
7350 Clearwater Rd
#201
Baxter, MN 56425
50 Centracare Dr
Long Prairie, MN 56347
Phone (320) 732-2131
525 Main St W
Melrose, MN 56352
Phone (320) 256-4228
425 Elm St N
Sauk Centre, MN 56378
Phone (320) 352-2221
Interoperability endpoints
- sutecht828298@direct.centracare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 2457064 | MN | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Nurse Practitioner | 363LF0000X | 10893 | MN | Yes |
Addresses
Primary practice location
50 Centracare Dr
Long Prairie, MN 56347-2100
Mailing address
50 Centracare Dr
Long Prairie, MN 56347-2100
Phone (320) 732-2131
Other providers in Long Prairie, MN
- Danielle Kreemer, LMFT, LLC
- Michael Denery
- Toni Nicole Drum
- Rene Eldidy Jr.
- Embrace Recovery, LLC
- Benjamin Woodrow Fritchman
- Ceree E. George
- Bobbie Jo Marie Haagenson
- Christopher Allan Hagen
- Haven Road Recovery Center, LLC
All providers in Long Prairie, MN · Family Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.