Andrea Shannon, R.N.

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

605762-1 Issued in NY

Practice address

23 Horton St
West Islip, NY 11795-1039

Phone

(631) 242-2247

Fax

(631) 242-2247

NPI assigned

May 19, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242691200000",
    "number": "1770718702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 HORTON ST",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117951039",
            "telephone_number": "631-242-2247",
            "fax_number": "631-242-2247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 HORTON ST",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117951039",
            "telephone_number": "631-242-2247",
            "fax_number": "631-242-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-19",
        "last_updated": "2009-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "605762-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Registered Nurse in West Islip, NY
• Providers in West Islip, NY by specialty
• Home Health Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; 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.