Shannon Jean Foley, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R140287 Issued in MD

Practice address

9748 Stephen Decatur Hwy Ste 104
Ocean City, MD 21842-9358

Phone

(410) 390-5954

NPI assigned

Oct 6, 2022

Last updated

Dec 11, 2023By 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 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1639894165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11702 ASSATEAGUE RD",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218112416",
            "telephone_number": "443-235-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9748 STEPHEN DECATUR HWY STE 104",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "218429358",
            "telephone_number": "410-390-5954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11702 Assateague Rd",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "MD",
            "postal_code": "218112416",
            "country_code": "US",
            "telephone_number": "443-235-3451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "34172 Citizen Dr",
            "address_purpose": "LOCATION",
            "city": "Lewes",
            "state": "DE",
            "postal_code": "199584777",
            "country_code": "US",
            "telephone_number": "302-827-2125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOLEY",
        "first_name": "SHANNON",
        "middle_name": "JEAN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-06",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "DE",
            "license": "LP-0010585",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R140287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND LICENSE",
            "identifier": "R140287",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PVS SECURITY CODE",
            "identifier": "0125008",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "LP0010585",
            "state": "DE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "beachbotox@comcast.net",
            "affiliation": "N",
            "endpointDescription": "VPN",
            "address_1": "11702 Assateague Rd",
            "city": "Berlin",
            "state": "MD",
            "country_code": "US",
            "postal_code": "218112416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Ocean City, MD
• Providers in Ocean City, MD by specialty
• Adult Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.