Shannon Miller Ullman, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

106952 Issued in WV

Practice address

489 Washington Ave
Clarksburg, WV 26301-2825

Phone

(304) 622-2708

NPI assigned

Jul 31, 2020

Last updated

Sep 10, 2020By 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

• Shannon Keats Miller Former name

Medicare fee-for-service enrollment

Enrolled in WV

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Camden-Clark Physician CorporationGroup PAC ID 5294885661, 345 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Camden Clark Medical Center Hospital, Parkersburg, WV, CCN 510058
• Jackson General Hospital Hospital, Ripley, WV, CCN 511320
• Marietta Memorial Hospital Hospital, Marietta, OH, CCN 360147

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Camden-Clark Physician Corporation

  • Surgery Physician
  • Parkersburg, WV
  • NPI 1710125430
  Medicare reassignment Care Compare group NPD
• Camden Clark Memorial Hospital Corporation

  dba Camden Clark Medical Center

  • General Acute Care Hospital
  • Parkersburg, WV
  • NPI 1699704254
  NPD (past)
• Health Access Inc

  • Clinic Pharmacy
  • Clarksburg, WV
  • NPI 1568723179
  NPD (past)
• Health Access, Inc.

  • Health Service Clinic/Center
  • Clarksburg, WV
  • NPI 1346458023
  NPD (past)

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

• Camden Clark Memorial Hospital Corporation

  • General Acute Care Hospital
  • Parkersburg, WV
  • NPI 1508160268
  Care Compare affiliation
• Camden Clark Memorial Hospital Corporation

  dba Camden Clark Medical Center

  • General Acute Care Hospital
  • Parkersburg, WV
  • NPI 1699704254
  Care Compare affiliation
• Community Health Association

  • Family Medicine Physician
  • Ripley, WV
  • NPI 1235753286

  Hospital

  Care Compare affiliation
• Community Health Association

  dba Jackson General Hospital

  • Critical Access Hospital
  • Ripley, WV
  • NPI 1649277476
  Care Compare affiliation
• Marietta Memorial Hospital

  • General Acute Care Hospital
  • Marietta, OH
  • NPI 1215936927
  Care Compare affiliation

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

{
    "created_epoch": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1871102277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 EASTERN TRL",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265085991",
            "telephone_number": "845-863-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 WASHINGTON AVE",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263012825",
            "telephone_number": "304-622-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLMAN",
        "first_name": "SHANNON",
        "middle_name": "MILLER",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-31",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "106952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "MILLER",
            "middle_name": "KEATS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paris Cleopatra Turner, PMHNP
• Tommy Turner, M.D.
• Tuscan Sun Spa
• Kenaira Ixtzel Ubiles-Martinez
• Ucfa Physicians Network Group of West Virginia
• Tonya Marie Smith Umbel, OD
• Amanda Underwood
• Brittany Underwood
• Emilee Hope Underwood
• United Hospital Center

• Family Nurse Practitioner in Clarksburg, WV
• Providers in Clarksburg, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; 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.