Shannon Duge Bartell, CPNP
Individual provider Active NPI Pediatric Nurse Practitioner · Helotes, TX
NPI 1669720785 · NPPES record last updated Aug 21, 2012
Key facts
- NPI
- 1669720785
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 751834 (TX)
- Practice address
- 12274 Bandera Rd
Suite 106
Helotes, TX 78023-4385 - Phone
- (210) 372-0505
- Fax
- (210) 372-0404
- NPI assigned
- Aug 21, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Texas Medical School at San Antonio, 2012
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
14100 San Pedro Ave
Suite 200
San Antonio, TX 78232-4396
731 Pepperbush Dr
Myrtle Beach, SC 29579-4163
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260408003467 | TX | Practitioner - Nurse Practitioner | 5193290021 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 751834 | TX | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Synergy Healthcare Associates, PLLC | Pediatrics | Current |
Accepting new patients |
| Helotes Pediatrics, P.a. | Past | Accepting new patients |
Locations
1028 Country Ln
Castroville, TX 78009
Phone (210) 232-6464
300 E Sonterra Blvd
Ste 320
San Antonio, TX 78258
Phone (210) 619-2710
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 751834 | TX | Yes |
Addresses
Primary practice location
12274 Bandera Rd
Suite 106
Helotes, TX 78023-4385
Mailing address
12274 Bandera Rd
Suite 106
Helotes, TX 78023-4385
Phone (210) 372-0505
Other providers in Helotes, TX
- Roderick Glen Ayers III
- Shubjit Kaur Bajwa
- Marcela Lessandra Barahona
- Kristen L Barnes
- Barrio Comprehensive Family Health Care Center, Inc.
- Barton Springs Neurology, PLLC
- Shireen A Bashiri
- Mark Joseph Bauernfeind
- Debra Bayard
- Natalya Bejar
All providers in Helotes, TX · Pediatric Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.