Jennifer Lynn Shull, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

383051 Issued in NY

Practice address

183 Park St
Malone, NY 12953-1242

Phone

(518) 481-2600

NPI assigned

Sep 23, 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

Medicare fee-for-service enrollment

Enrolled in NY

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

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jshull465461@direct.uvmhealth.org

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.

• Alice Hyde Medical Center

  • Critical Access Hospital
  • Malone, NY
  • NPI 1114954682
  Medicare reassignment NPD
• Alice Hyde Medical Center

  • General Practice Physician
  • Malone, NY
  • NPI 1568735660
  NPD
• Alice Hyde Medical Center

  • Skilled Nursing Facility
  • Malone, NY
  • NPI 1356441349
  NPD (past)

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1780235622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 PARK ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531242",
            "telephone_number": "518-481-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 PARK ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531242",
            "telephone_number": "518-481-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULL",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilhelmina Marie Sheridan, FNP
• Carl P Sherwin, MD
• Ryan Patrick Shippee
• Brittany Marie Shorette, RN
• Morgan Short
• Sandra Jones Shutler, RN
• Andrii Shykota, DMD
• Valerie Simmons
• Nathalie Simprevil
• Dakota Marie Simpson

• Pediatric Nurse Practitioner in Malone, NY
• Providers in Malone, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.