Individual provider Active NPI

Paige Christine Shannon, ACNPBC-AG

  • Acute Care Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1780107383
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
0024176743 Issued in VA
Practice address
5875 Bremo Rd Ste 400B
Richmond, VA 23226-1928
Phone
(804) 287-7840
NPI assigned
Jul 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X VA-0001239292 VA
Acute Care Nurse Practitioner 363LA2100X F432393-01 NY
Acute Care Nurse Practitioner 363LA2100X 0024176743 VA Primary

Addresses

Primary practice location

5875 Bremo Rd Ste 400B
Richmond, VA 23226-1928

Mailing address

630 W 168TH St # 4
New York, NY 10032-3725

Other practice location 1

177 Fort Washington Ave
New York, NY 10032-3733
Phone (212) 305-6345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211004000902 VA Practitioner - Nurse Practitioner 1850658477 Reassigns benefits to 2 organizations
I20240807003745 NY Practitioner - Nurse Practitioner 1850658477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Virginia School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1510 N 28TH St
Richmond, VA 23223-5311

5875 Bremo Rd
Richmond, VA 23226-1934

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F432393-01NYMDAcute Care Nurse Practitioner
0024176743VAMDAcute Care Nurse Practitioner
VA-0001239292VAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Mar 23, 2025 Accepting new patients
University of Virginia Physicians Group CurrentSince Sep 20, 2021 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jun 1, 2024 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Mar 23, 2025 Accepting new patients

Locations

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

300 Community Dr
Plandome, NY 11030

1215 Lee St
Fl 1
Charlottesville, VA 22908
Phone (434) 924-9400

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

8220 Meadowbridge Rd
Ste 306
Mechanicsvlle, VA 23116
Phone (804) 764-1253

5875 Bremo Rd
Ste 400B
Richmond, VA 23226
Phone (804) 287-7690

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

Interoperability endpoints

  • Direct secure messaging: pshannon2792914@direct.bsmhealth.org

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1780107383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST # 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 BREMO RD STE 400B",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261928",
            "telephone_number": "804-287-7840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "177 Fort Washington Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323733",
            "country_code": "US",
            "telephone_number": "212-305-6345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "PAIGE",
        "middle_name": "CHRISTINE",
        "credential": "ACNPBC-AG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "VA-0001239292",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F432393-01",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024176743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.