NPIMap

Individual provider Active NPI

Shelley Ann Nicole Pennycooke

  • Emergency Medicine Physician
  • Wilkes Barre, PA
National Provider Identifier
1821297938
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS024274 Issued in PA
Practice address
1000 E Mountain Dr
Wilkes Barre, PA 18711-0027
Phone
(570) 808-7762
Fax
(570) 808-6128
NPI assigned
Jul 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS024274 PA Primary

Addresses

Primary practice location

1000 E Mountain Dr
Wilkes Barre, PA 18711-0027

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 808-7762

Other identifiers 2

IdentifierTypeStateIssuer
P00766006OtherNJRR MEDICARE
0181943MedicaidNJ

Other names 1

  • Shelley Ann Nicole Murray Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, MI, TX, ME, PA5 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20090108000246 NJ Practitioner - Emergency Medicine 1759444375 Reassigns benefits to 3 organizations
I20250331000261 MI Practitioner - Emergency Medicine 1759444375 Reassigns benefits to 2 organizations
I20250915002941 TX Practitioner - Emergency Medicine 1759444375 Reassigns benefits to 1 organization
I20251104002717 ME Practitioner - Emergency Medicine 1759444375 Reassigns benefits to 1 organization
I20251114000408 PA Practitioner - Emergency Medicine 1759444375 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physician Associates of North Jersey P CGroup PAC ID 7911992326, 125 clinicians
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
McLaren Medical GroupGroup PAC ID 3971416082, 240 clinicians

Practice addresses (Care Compare)

1 Riverview PLZ
Red Bank, NJ 07701-1864
Phone (908) 522-2232

1000 E Mountain Dr
Wilkes Barre, PA 18711-0027
Phone (570) 826-7300

1900 Columbus Ave
Bay City, MI 48708-6831
Phone (989) 894-3000

Hospital & facility affiliations

  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270
  • Bayshore Medical Center Hospital, Holmdel, NJ, CCN 310112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS024274PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Oct 20, 2025 Accepting new patients
Geisinger Clinic CurrentSince Oct 20, 2025 Accepting new patients
McLaren Medical Group Emergency Medicine CurrentSince Feb 12, 2025 Accepting new patients
Geisinger Clinic Current Accepting new patients
McLaren Medical Group CurrentSince Feb 12, 2025 Accepting new patients
Geisinger-HM Joint Venture, LLC Current Accepting new patients
Doctors Office of Brick CurrentSince Jan 1, 2016 Accepting new patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients
Bluewater Emergency Partners of Brunswick, LLC Emergency Medicine CurrentSince Aug 29, 2025 Accepting new patients
McLaren Hospital Group Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Oct 20, 2025 Accepting new patients
Eastern Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

123 Medical Center Dr
Brunswick, ME 04011
Phone (207) 373-6800

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

39373 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 286-4880

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

484 Temple Hill Rd
Ste 104
New Windsor, NY 12553
Phone (732) 896-4444

484 Temple Hill Rd
Ste 103
New Windsor, NY 12553

100 N Academy Ave
Danville, PA 17822

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

255 Route 220 Hwy
Muncy, PA 17756
Phone (570) 308-2600

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1821297938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-808-7762",
            "fax_number": "570-808-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E MOUNTAIN DR",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110027",
            "telephone_number": "570-808-7762",
            "fax_number": "570-808-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNYCOOKE",
        "first_name": "SHELLEY ANN",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS024274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00766006",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0181943",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLEY ANN",
            "last_name": "MURRAY",
            "middle_name": "NICOLE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.