Individual provider Active NPI

Shornett Codiann Fletcher, NP

  • Family Nurse Practitioner
  • Elkton, MD
National Provider Identifier
1831922210
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0012742 Issued in MD
Practice address
115 Erin CT
Elkton, MD 21921-6692
Phone
(954) 955-1709
NPI assigned
Aug 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X LG-0012742 MD Primary

Addresses

Primary practice location

115 Erin CT
Elkton, MD 21921-6692

Mailing address

115 Erin CT
Elkton, MD 21921-6692
Phone (954) 955-1709

Other practice location 1

303 E Lea Blvd
Wilmington, DE 19802-2353
Phone (302) 476-8896

Other identifiers 1

IdentifierTypeStateIssuer
13-4205050MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20250108003899 DE Practitioner - Nurse Practitioner 5597293290 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

Practice addresses (Care Compare)

4110 Ogletown Stanton Rd
Newark, DE 19713-4169
Phone (302) 738-0103

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LG-0012742MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of Delaware P.a. Multi-Specialty CurrentSince Jan 6, 2025 Accepting new patients
Dr. Clyde a. Maxwell Jr, PA PastSince Jun 30, 2024 Accepting new patients

Locations

4110 Stanton Ogletown Rd
Newark, DE 19713
Phone (302) 738-0103

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 2

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": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1831922210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ERIN CT",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219216692",
            "telephone_number": "954-955-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ERIN CT",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219216692",
            "telephone_number": "954-955-1709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 E Lea Blvd",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198022353",
            "country_code": "US",
            "telephone_number": "302-476-8896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "SHORNETT",
        "middle_name": "CODIANN",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-22",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "LG-0012742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13-4205050",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

Verify at the official NPI Registry.