Individual provider Active NPI

Shannon Marie Patchen, CNP

  • Nurse Practitioner
  • Fridley, MN
National Provider Identifier
1679125157
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6452 Issued in MN
Practice address
7590 Lyric LN NE
Fridley, MN 55432-3251
Phone
(763) 236-4300
NPI assigned
Jul 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 6452 MN
Nurse Practitioner 363L00000X 6452 MN Primary

Addresses

Primary practice location

7590 Lyric LN NE
Fridley, MN 55432-3251

Mailing address

2925 Chicago Avenue
Minneapolis, MN 55407-1321
Phone (612) 262-5000

Other practice location 1

7590 Lyric LN NE
Fridley, MN 55432-3251
Phone (763) 236-4300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Shannon.patchen@allinahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190823000951 MN Practitioner - Nurse Practitioner 7719215151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

520 Osborne Rd NE
Suite 120
Fridley, MN 55432-2718
Phone (763) 236-4300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
6452MNMDNutrition Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Aug 5, 2019 Accepting new patients
Allina Health System CurrentSince Aug 5, 2019 Accepting new patients
Allina Health System Past Accepting new patients

Locations

520 Osborne Rd NE
Ste 120
Fridley, MN 55432
Phone (763) 236-4300

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

550 Osborne Rd NE
Minneapolis, MN 55432
Phone (763) 236-3800

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

7590 Lyric Ln NE
Minneapolis, MN 55432
Phone (763) 236-3800

Interoperability endpoints

  • Direct secure messaging: spatchen129976@excellian.direct.allina.com
  • Direct secure messaging: shannon.patchen@allinahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1679125157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVENUE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7590 LYRIC LN NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554323251",
            "telephone_number": "763-236-4300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7590 Lyric LN NE",
            "address_purpose": "LOCATION",
            "city": "Fridley",
            "state": "MN",
            "postal_code": "554323251",
            "country_code": "US",
            "telephone_number": "763-236-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATCHEN",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "6452",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "6452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Shannon.patchen@allinahealth.com",
            "affiliation": "N",
            "address_1": "550 Osborne Rd NE",
            "city": "Fridley",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554322718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

Verify at the official NPI Registry.