Individual provider Active NPI

Shannon Reynolds, CRNP

  • Family Nurse Practitioner
  • King of Prussia, PA
National Provider Identifier
1720449747
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP015801 Issued in PA
Practice address
120 Valley Green LN Ste 510
King of Prussia, PA 19406-2080
Phone
(484) 324-7171
NPI assigned
Mar 18, 2016
Last updated
Sep 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP015801 PA
Family Nurse Practitioner 363LF0000X SP015801 PA Primary

Addresses

Primary practice location

120 Valley Green LN Ste 510
King of Prussia, PA 19406-2080

Mailing address

3803 W Chester Pike Ste 160
Newtown Square, PA 19073-2336
Phone (484) 337-1632

Other practice location 1

25 Settlers Path
Parkesburg, PA 19365-9168
Phone (717) 799-7625

Other practice location 2

1250 S Cedar Crest Blvd Ste 405
Allentown, PA 18103-6224
Phone (610) 402-6755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20160812000075 PA Practitioner - Nurse Practitioner 5698739217 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

120 Valley Green Lane
Suite 510
King of Prussia, PA 19406
Phone (484) 324-7100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP015801PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Health Access Network, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Emergency Care Services of Pennsylvania, P.C. CurrentSince Jul 1, 2019 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Emergency Care Services of Pennsylvania, P.C. CurrentSince Jul 1, 2019 Accepting new patients
Lehigh Valley Physician Group CurrentSince Feb 11, 2019 Accepting new patients
Lehigh Valley Physician Group CurrentSince Feb 11, 2019 Accepting new patients
Lehigh Valley Physician Group Nurse Practitioner Current Accepting new patients
Prospect Health Access Network, Inc. Current Accepting new patients
Main Line Healthcare Nurse Practitioner CurrentSince Jul 5, 2025 Accepting new patients

Locations

1250 S Cedar Crest Blvd
Ste 400
Allentown, PA 18103
Phone (610) 402-3650

1250 S Cedar Crest Blvd
Ste 405
Allentown, PA 18103
Phone (610) 402-8420

2100 Mack Blvd
Fl 4
Allentown, PA 18103

1770 Bathgate Rd
Ste 402
Bethlehem, PA 18017
Phone (484) 884-8950

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

501 N Lansdowne Ave
Drexel Hill, PA 19026
Phone (610) 284-8100

120 Valley Green Ln
Ste 510
King of Prussia, PA 19406
Phone (484) 324-7100

281 N 12th St
Ste B
Lehighton, PA 18235
Phone (610) 377-7793

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

1201 Langhorne Newtown Rd
Penndel, PA 19047
Phone (215) 710-2100

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

Organizations & group practices 9

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.

Hospital & facility affiliations 3

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": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1720449747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336",
            "telephone_number": "484-337-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 VALLEY GREEN LN STE 510",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062080",
            "telephone_number": "484-324-7171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Settlers Path",
            "address_purpose": "LOCATION",
            "city": "Parkesburg",
            "state": "PA",
            "postal_code": "193659168",
            "country_code": "US",
            "telephone_number": "717-799-7625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 S Cedar Crest Blvd Ste 405",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181036224",
            "country_code": "US",
            "telephone_number": "610-402-6755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "SHANNON",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-18",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP015801",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP015801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

Verify at the official NPI Registry.