Shannon Wound Care Consultants LLC

Key facts

NPI

1649405960

Entity type

Organization (NPI type 2)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

SP007840 (PA)

Legal business name

SHANNON WOUND CARE CONSULTANTS LLC

Practice address

318 Conerty Rd
Chicora, PA 16025-1820

Phone

(724) 355-3060

NPI assigned

May 17, 2009

Organization subpart

No

Authorized official

Name

Mrs. Mary McVaugh Shannon NPI 1104816073

Title

President

Phone

(724) 355-3060

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary M Shannon, CRNP Family Nurse Practitioner · Kittanning, PA · NPI 1104816073
  Medicare reassignment Authorized official PA

Medicare participation

Medicare fee-for-service enrollment

Enrolled in PA

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 11, 2009.

{
    "created_epoch": "1242518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247270400000",
    "number": "1649405960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 CONERTY RD",
            "city": "CHICORA",
            "state": "PA",
            "postal_code": "160251820",
            "telephone_number": "724-355-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 CONERTY RD",
            "city": "CHICORA",
            "state": "PA",
            "postal_code": "160251820",
            "telephone_number": "724-355-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON WOUND CARE CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-17",
        "last_updated": "2009-07-11",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "MCVAUGH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "724-355-3060",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP007840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicora, PA

• Quality Pharmacy LP
• John Oldford Rea, RPH
• Sarah Renee Rodgers, SLP
• Christopher Robert Rugaber, OD
• Matthew James Sabo, DPM
• Janine Marie Sisko
• Rachel Wilson, MS, CCC-SLP
• Joseph Yeager, DPT, ATC

All providers in Chicora, PA · Family Nurse Practitioner in Pennsylvania