Kelly Ann Shannon, RN BSN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

RN514529L Issued in PA

Practice address

80 Yellowwood Dr
Downingtown, PA 19335-4610

Phone

(610) 564-8598

NPI assigned

Jan 15, 2024

Last updated

Jan 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly Ann Young Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1871364224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 YELLOWWOOD DR",
            "city": "DOWNINGTOWN",
            "state": "PA",
            "postal_code": "193354610",
            "telephone_number": "610-564-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 YELLOWWOOD DR",
            "city": "DOWNINGTOWN",
            "state": "PA",
            "postal_code": "193354610",
            "telephone_number": "610-564-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "KELLY ANN",
        "credential": "RN BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "PA",
            "license": "RN514529L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY ANN",
            "last_name": "YOUNG",
            "credential": "RN BSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• General Practice Registered Nurse in Downingtown, PA
• Providers in Downingtown, PA by specialty
• General Practice Registered Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; 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.