Individual provider Active NPI

Shannon M Schneider, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1790547016
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RNP302869 Issued in AZ
Practice address
9610 N Metro Pkwy W
Phoenix, AZ 85051-1402
Phone
(480) 964-2273
NPI assigned
Jan 24, 2024
Last updated
Oct 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RNP302869 AZ Primary

Addresses

Primary practice location

9610 N Metro Pkwy W
Phoenix, AZ 85051-1402

Mailing address

9610 N Metro Pkwy W
Phoenix, AZ 85051-1402
Phone (480) 964-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20240823003567 AZ Practitioner - Nurse Practitioner 1153860945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adelante Healthcare, IncGroup PAC ID 4688588643, 132 clinicians

Practice addresses (Care Compare)

3033 N Central Ave
Suite 145
Phoenix, AZ 85012-2808

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RNP302869AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adelante Healthcare, Inc. Current Accepting new patients
Adelante Healthcare, Inc CurrentSince Jul 1, 2024 Accepting new patients
Adelante Healthcare, Inc. CurrentSince Jul 1, 2024 Accepting new patients

Locations

306 E Monroe Ave
Buckeye, AZ 85326
Phone (623) 386-1630

13471 W Cornerstone Blvd
Goodyear, AZ 85395

1705 W Main St
Mesa, AZ 85201
Phone (480) 845-6769

15525 N 83rd Ave
Ste 104
Peoria, AZ 85382

3033 N Central Ave
Ste 145
Phoenix, AZ 85012

3130 E Roosevelt St
Bldg C
Phoenix, AZ 85008
Phone (480) 904-7787

500 W Thomas Rd
Ste 870
Phoenix, AZ 85013
Phone (602) 263-0222

9610 N Metro Pkwy W
Phoenix, AZ 85051
Phone (602) 843-1560

15317 W Bell Rd
Ste 100
Surprise, AZ 85374

15317 W Bell Rd
Ste 106
Surprise, AZ 85374
Phone (623) 544-5190

15351 W Bell Rd
Surprise, AZ 85374

811 N Tegner St
Ste 113
Wickenburg, AZ 85390

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1790547016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9610 N METRO PKWY W",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850511402",
            "telephone_number": "480-964-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9610 N METRO PKWY W",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850511402",
            "telephone_number": "480-964-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "SHANNON",
        "middle_name": "M",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RNP302869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.