Individual provider Active NPI

Jocelyn Shannon, RN

  • General Practice Registered Nurse
  • Hagerstown, MD
National Provider Identifier
1841003951
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
R206255 Issued in MD
Practice address
13214 Fountain Head PLZ
Hagerstown, MD 21742-2678
Phone
(301) 766-9293
NPI assigned
Jan 31, 2025
Last updated
Jan 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X R206255 MD Primary

Addresses

Primary practice location

13214 Fountain Head PLZ
Hagerstown, MD 21742-2678

Mailing address

20907 Mount Aetna Rd
Hagerstown, MD 21742-1127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R206255MDMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sef Development LLC CurrentSince Aug 25, 2025 Accepting new patients
Structural Elements, LLC PastSince Feb 2, 2025 Accepting new patients

Locations

13214 Fountain Head Plz
Hagerstown, MD 21742
Phone (301) 766-9293

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, 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": "1738281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1841003951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20907 MOUNT AETNA RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217421127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13214 FOUNTAIN HEAD PLZ",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217422678",
            "telephone_number": "301-766-9293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "JOCELYN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-31",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MD",
            "license": "R206255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.