Shannon Braslavsky, AGPNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

A004140 Issued in AR

Practice address

3555 Stone Creek Cir SW
Cedar Rapids, IA 52404-1240

Phone

(319) 693-8800

Fax

(319) 208-2273

NPI assigned

Jul 22, 2014

Reactivated

Jan 17, 2025

Last updated

Jan 29, 2025By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Iowa Wellness Clinic PLLC

  dba Vitaluty Wellness

  • Nurse Practitioner
  • Cedar Rapids, IA
  • NPI 1811748049
  NPD Authorized official
• Bryant Family Medical Clinic, P.a.

  • Medical Specialty Clinic/Center
  • Bryant, AR
  • NPI 1073640769
  NPD
• Cloud Health Medical Group, P.a.

  • Internal Medicine Physician
  • White Plains, NY
  • NPI 1528744935
  NPD (past)

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1881001899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 B AVE NE",
            "city": "WALFORD",
            "state": "IA",
            "postal_code": "523518018",
            "telephone_number": "501-943-9070",
            "fax_number": "319-208-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 STONE CREEK CIR SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524041240",
            "telephone_number": "319-693-8800",
            "fax_number": "319-208-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "408 Office Park Dr",
            "address_purpose": "LOCATION",
            "city": "Bryant",
            "state": "AR",
            "postal_code": "720227534",
            "country_code": "US",
            "telephone_number": "501-847-2835",
            "fax_number": "501-847-6809",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4200 Regent St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432196229",
            "country_code": "US",
            "telephone_number": "877-581-2210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRASLAVSKY",
        "first_name": "SHANNON",
        "credential": "AGPNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "deactivation_date": "2025-01-07",
        "reactivation_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A004140",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "A004140",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AR",
            "license": "A004140",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ignatius J Brady, MD
• Robert Braksiek, MD
• Brandis McFarland Ma, LMHC Mental Health Counseling PLLC
• Olivia Brands
• Karley Brantman, DDS
• Nancy Ellen Brauhn, PH.D
• Breaking Barriers Therapy Center
• Shelby Breberg, BSW
• Jessica Jade Brecht
• Elizabeth Breen, LMSW

• Nurse Practitioner in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.