Shawnee Renee Fudurich, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

224194 Issued in AZ

Practice address

10230 W Happy Valley Pkwy Ste 100
Peoria, AZ 85383-4255

Phone

(623) 561-3030

NPI assigned

May 8, 2019

Last updated

May 8, 2019By the provider in NPPES

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

Other names 1

• Shawnee Renee Brunnemer Former name

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Honorhealth Medical Group, LLCGroup PAC ID 1557274057, 338 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Honor Health John C. Lincoln Medical Center Hospital, Phoenix, AZ, CCN 030014

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sfudurich196353@direct.honorhealth.com

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.

• Honorhealth Medical Group, LLC

  • Primary Care Clinic/Center
  • Peoria, AZ
  • NPI 1043851793
  Medicare reassignment Care Compare group NPD
• Honorhealth Medical Group, LLC

  dba Plaza del Rio Family Medicine

  • Family Medicine Physician
  • Peoria, AZ
  • NPI 1073916938
  NPD
• Honorhealth Medical Group, LLC

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1285338343
  NPD
• Squaw Peak Family Physicians PC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1578590303
  NPD

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

• Honorhealth

  dba HonorHealth John C. Lincoln Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1770690695
  Care Compare affiliation

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1861057507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28508 N 66TH LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850837599",
            "telephone_number": "623-670-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10230 W HAPPY VALLEY PKWY STE 100",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853834255",
            "telephone_number": "623-561-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUDURICH",
        "first_name": "SHAWNEE",
        "middle_name": "RENEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-08",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "224194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWNEE",
            "last_name": "BRUNNEMER",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Phillip Fromm, DMD
• Yvonne Fronczek, OTR
• FSL Pathways (AllThrive365 BHS)
• FSL Pathways (AllThrive365 BHS)
• FSL Programs
• Fun Time Therapy LLC
• Blair Funk, MD
• Fusion Therapies PLLC
• Erin Rae Fyffe, RN, IBCLC
• G & J Personal Care, LLC

• Family Nurse Practitioner in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.