Shannon Creedon, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN11014376 Issued in FL

Practice address

3488 Depew Ave
Port Charlotte, FL 33952-7015

Phone

(941) 764-7923

NPI assigned

Sep 22, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

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.

• Cepero Pediatrics, P.a.

  • Pediatrics Physician
  • Port Charlotte, FL
  • NPI 1619233509

  Single Specialty

  NPD (past)
• Weiss Pediatric Care, LLC

  • Pediatrics Physician
  • Sarasota, FL
  • NPI 1063759314

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1548639487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 BRIGGSBORO LN",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503805",
            "telephone_number": "315-507-1878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3488 DEPEW AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339527015",
            "telephone_number": "941-764-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREEDON",
        "first_name": "SHANNON",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-22",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "686564",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN11014376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura M Cox, M.D.
• Crack It Chiropractic LLC
• Stephanie Craft
• Joanne Crandall, LMHC
• Amelia Crawford, DMD
• Crews-Ing Chair Company, LLC
• Cathy L Criss, DO
• Patricia Ann Crist, OTR/L
• Carissa Crites
• Erica Cromwell

• Pediatric Nurse Practitioner in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.