Shannon L Wilson, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

MW010264 Issued in PA

Practice address

175 E Brown St
Suite 113
East Stroudsburg, PA 18301-3098

Phone

(570) 421-3401

Fax

(570) 421-0560

NPI assigned

Mar 30, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lehigh Valley Hospital - Pocono Hospital, East Stroudsburg, PA, CCN 390201

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

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 and National Provider Directory roles.

• Lehigh Valley Physician Group

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1780155689

  PA

  Medicare reassignment Care Compare group
• Family Care Centers Inc.

  • Internal Medicine Physician
  • E Stroudsburg, PA
  • NPI 1669563037

  PA

  Medicare reassignment NPD
• Hazleton Professional Services

  • Internal Medicine Physician
  • Hazleton, PA
  • NPI 1952464638

  PA

  Medicare reassignment NPD
• Schuylkill Health System Medical Group, Inc.

  • Internal Medicine Physician
  • Pottsville, PA
  • NPI 1588603567

  PA

  Medicare reassignment NPD
• Lehigh Valley Physician Group

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1245093368
  NPD
• Lehigh Valley Physician Group

  • Surgery Physician
  • Allentown, PA
  • NPI 1447700018
  NPD
• Lehigh Valley Physician Group

  • Transplant Surgery Physician
  • Allentown, PA
  • NPI 1457309650
  NPD
• Lehigh Valley Physician Group

  • General Practice Physician
  • Hazleton, PA
  • NPI 1942609599
  NPD
• Schuylkill Health System Medical Group, Inc.

  • Emergency Medicine Physician
  • Pottsville, PA
  • NPI 1063073823
  NPD

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

• Lehigh Valley Hospital Pocono

  • General Acute Care Hospital
  • East Stroudsburg, PA
  • NPI 1568459436

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333065600000",
    "number": "1629344981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 E BROWN ST",
            "address_2": "POCONO HEALTHCARE MANAGEMENT",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013006",
            "telephone_number": "570-420-4951",
            "fax_number": "570-476-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E BROWN ST",
            "address_2": "SUITE 113",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013098",
            "telephone_number": "570-421-3401",
            "fax_number": "570-421-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHANNON",
        "middle_name": "L",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-30",
        "last_updated": "2012-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "PA",
            "license": "MW010264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry Williams, CRNP
• Lauren Rebecca Willie, PA-C
• Garth J. Willis, M.D.
• Natasha Anastasia Bonit Wills
• Emilia Jadwiga Wilman, PTA
• Patricia Wingerter
• Ashley Nicole Winkelspecht, ATC
• Hailey Joy Winnicky
• Tridaugh D Winston, PA
• Sean Wisneiski, LMSW

• Advanced Practice Midwife in East Stroudsburg, PA
• Providers in East Stroudsburg, PA by specialty
• Advanced Practice Midwife in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; 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.