Shannon D Burris, NP
Individual provider Active NPI Nurse Practitioner · Mathews, VA
NPI 1679548705 · NPPES record last updated Apr 28, 2015
Key facts
- NPI
- 1679548705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 0024134311 (VA)
- Practice address
- 28 Church St
Mathews, VA 23109 - Phone
- (804) 725-4115
- Fax
- (804) 725-4201
- NPI assigned
- Feb 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Sentara Medical Group
Practice addresses (Care Compare)
11803 Jefferson Ave
Newport News, VA 23606-4390
5659 Pkwy Dr
Gloucester, VA 23061-3792
830 Kempsville Rd
2B223
Norfolk, VA 23502-3920
Phone (757) 261-8860
850 Kempsville Rd
Norfolk, VA 23502-3920
Hospital & facility affiliations
- Riverside Home Health
- Sentara Home Care Services
- Sentara Williamsburg Regional Medical Center
- Riverside Walter Reed Hospital
- Sentara Careplex Hospital
- Riverside Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- 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 |
|---|---|---|---|---|
| I20060509000186 | VA | Practitioner - Nurse Practitioner | 0840201687 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sentara Medical Group | Current |
Accepting new patients |
Locations
5659 Parkway Dr
Ste 210
Gloucester, VA 23061
Phone (804) 210-1025
850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162
Interoperability endpoints
- sburris30578@direct.sentara.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 0024134311 | VA | Yes |
Addresses
Primary practice location
28 Church St
Mathews, VA 23109
Mailing address
28 Church St
Mathews, VA 23109
Phone (804) 725-4115
Other providers in Mathews, VA
- Aurora Family Services
- Diana Lynn Bandurco
- Sabra M Bellovin
- Christine Bott-Schmuker
- Kimberly Odel Burnett
- Christy B. Brown, Inc.
- Commonwealth of Virginia State Board of Health
- Jessica Tracy Deamer
- Kristine L Dutton
- Paul Thomas Edwards
All providers in Mathews, VA · Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2015. 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.