Shannon Smith, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R198429 Issued in MD

Practice address

1400 Coastal Hwy
Fenwick Island, DE 19944-4452

Phone

(443) 373-3245

Fax

(443) 513-3679

NPI assigned

Sep 28, 2009

Last updated

Jan 5, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DE2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019
• Atlantic General Hospital Hospital, Berlin, MD, CCN 210061

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Geriatric Medicine Consultants PA

  • Internal Medicine Physician
  • Greenville, DE
  • NPI 1598031643
  Medicare reassignment NPD
• Ability Rehab Associates

  • Physical Medicine & Rehabilitation Physician
  • Salisbury, MD
  • NPI 1356444590
  Medicare reassignment NPD
• Atlantic Recovery, LLC

  • Family Medicine Physician
  • Salisbury, MD
  • NPI 1952812794

  DE

  Medicare reassignment NPD
• Five Star Physician Services, LLC

  • Internal Medicine Physician
  • Linthicum Heights, MD
  • NPI 1083654479
  Medicare reassignment NPD
• Bayside Health Holdings LLC

  • Nurse Practitioner
  • Berlin, MD
  • NPI 1700795135
  Authorized official Same address or phone

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

• Tidalhealth Atlantic, Inc

  dba Atlantic General Hospital Corp

  • General Acute Care Hospital
  • Berlin, MD
  • NPI 1053309120
  Care Compare affiliation
• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  Care Compare affiliation

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1588998207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1613",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218115613",
            "telephone_number": "443-513-0821",
            "fax_number": "443-513-3679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 COASTAL HWY",
            "city": "FENWICK ISLAND",
            "state": "DE",
            "postal_code": "199444452",
            "telephone_number": "443-373-3245",
            "fax_number": "443-513-3679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9715 Healthway Dr",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "MD",
            "postal_code": "218113500",
            "country_code": "US",
            "telephone_number": "443-373-3245",
            "fax_number": "443-513-3679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANNON",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0011482",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R198429",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R198429",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0011482",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Ray Blanck, D.O.
• Nicholas Nicholson Borodulia, M.D.
• Fenwick Medical Center PA
• Mary H Strong

• Family Nurse Practitioner in Fenwick Island, DE
• Providers in Fenwick Island, DE by specialty
• Family Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.