Shannon Marie Husted, FNP-BC, MSN, BSN, RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

13341645-8900 Issued in UT

Practice address

5021 Riverfront Dr
Suffolk, VA 23434-7188

Phone

(757) 319-2423

NPI assigned

Jul 11, 2021

Last updated

Apr 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 1

Other names 1

• Miss Shannon Marie Clark Former name

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bayview Physician Services, PC

  • Family Medicine Physician
  • Chesapeake, VA
  • NPI 1508813387
  Medicare reassignment NPD
• Bayview Physician Services, PC

  dba LMC Radiology

  • Radiology Clinic/Center
  • Suffolk, VA
  • NPI 1699865626
  NPD
• Bayview Medical Center, Inc

  dba LMC Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Suffolk, VA
  • NPI 1568466209
  NPD (past)

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

{
    "created_epoch": "1625961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1689246670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5021 RIVERFRONT DR",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234347188",
            "telephone_number": "757-319-2423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5021 RIVERFRONT DR",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234347188",
            "telephone_number": "757-319-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSTED",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "FNP-BC, MSN, BSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-11",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "13341645-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024185946",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "13341645-8900",
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "VA",
            "license": "0001160108",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMV",
            "identifier": "T26563035",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "CLARK",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lora Faulk Hunter
• Tiffany M Hunter, M.A. CCC-SLP
• Laura Lee Hurley
• Mavolyn Jones Hurt, RN
• Melanie Huss, LPC
• Anne L Hutchinson, D.O.
• Wisal Ibraheem
• Iliad Counseling Services LLC
• Ils Medical, Inc
• Immaculate Care Transportation LLC

• Family Nurse Practitioner in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.