Mary Ann Shinnick, PHD, ACNP, CNS

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

8478 Issued in CA

Practice address

1110 Arno Dr
Sierra Madre, CA 91024-1511

Phone

(626) 991-2912

NPI assigned

Sep 26, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mary Ann Shinnick-Wurmsdobler Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Specialist, Doctor of Philosophy

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1750932018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 ARNO DR",
            "city": "SIERRA MADRE",
            "state": "CA",
            "postal_code": "910241511",
            "telephone_number": "626-991-2912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 ARNO DR",
            "city": "SIERRA MADRE",
            "state": "CA",
            "postal_code": "910241511",
            "telephone_number": "626-991-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINNICK",
        "first_name": "MARY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHD, ACNP, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "8478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA NP FURNISHING NUMBER",
            "identifier": "8478",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP FURNISHING NUMBER",
            "identifier": "8478",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ANN",
            "last_name": "SHINNICK-WURMSDOBLER",
            "credential": "RN, NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Molly Ann Schardt, M.A.
• Kathryn Scott, M.A., MFT
• Anisha Sehgal, DMD
• Orna Sever, MD
• Anil Virendra Shah
• Alicia Siefers Roberts, CCC-SLP
• Sierra Madre Community Medical Group, Inc
• Sierra Madre Holistic Health
• Sierra Madre Learning Center Total Programs, LLC
• Sierra Madre Learning Center/Total Programs LLC

• Acute Care Nurse Practitioner in Sierra Madre, CA
• Providers in Sierra Madre, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.