Individual provider Active NPI

Shannon M Fitzpatrick, CMHC

  • Mental Health Counselor
  • Hiawatha, IA
National Provider Identifier
1548085590
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
114763 Issued in IA
Practice address
1340 Blairs Ferry Rd
Hiawatha, IA 52233-1900
Phone
(917) 817-5938
NPI assigned
Nov 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 114763 IA Primary

Addresses

Primary practice location

1340 Blairs Ferry Rd
Hiawatha, IA 52233-1900

Mailing address

1340 Blairs Ferry Rd
Hiawatha, IA 52233-1900
Phone (917) 817-5938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250128000481 IA Practitioner - Mental Health Counselor 9739618307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Medical CenterGroup PAC ID 4183535271, 295 clinicians

Practice addresses (Care Compare)

1340 Blairs Ferry Rd
Unit a
Hiawatha, IA 52233-1900
Phone (319) 398-6575

701 10TH St SE
Cedar Rapids, IA 52403-1251

701 10TH St SE J Edward Lundy
Mercy Pediatric Clinic
Cedar Rapids, IA 52403-1251
Phone (319) 832-2328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
114763IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center CurrentSince Dec 11, 2024 Accepting new patients
Mercy Medical Center CurrentSince Dec 11, 2024 Accepting new patients

Locations

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

1340 Blairs Ferry Rd
Unit A
Hiawatha, IA 52233
Phone (319) 398-6694

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1731628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1548085590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 BLAIRS FERRY RD",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522331900",
            "telephone_number": "917-817-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BLAIRS FERRY RD",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522331900",
            "telephone_number": "917-817-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "SHANNON",
        "middle_name": "M",
        "credential": "CMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-15",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "114763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiawatha, IA

Sources for this page

Verify at the official NPI Registry.