NPIMap

Individual provider Active NPI

Shannon Nicole Scandone, FNP-BC

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1881138873
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5009159 Issued in NC
Practice address
125 Queens Rd Ste 200
Charlotte, NC 28204-3578
Phone
(704) 343-9800
Fax
(704) 347-2011
NPI assigned
Dec 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5009159 NC
Nurse Practitioner 363L00000X 5009159 NC Primary

Addresses

Primary practice location

125 Queens Rd Ste 200
Charlotte, NC 28204-3578

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 343-9800

Other practice location 1

1718 E 4th St
Suite 501
Charlotte, NC 28204-3261
Phone (704) 347-2097

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sscandone426282@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170412001032 NC Practitioner - Nurse Practitioner 0648556340 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians

Practice addresses (Care Compare)

125 Queens Rd
Charlotte, NC 28204-3215

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-9073

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5009159NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Medical Group, Inc. CurrentSince Feb 13, 2017 Accepting new patients
The Presbyterian Hospital CurrentSince Feb 13, 2017 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
The Presbyterian Hospital CurrentSince Feb 13, 2017 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 19, 2020 Accepting new patients
The Presbyterian Hospital Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 13, 2017 Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

125 Queens Rd
Ste 200
Charlotte, NC 28204

1718 E 4th St
Ste 501
Charlotte, NC 28204
Phone (704) 868-3256

125 Queens Rd
Ste 330
Charlotte, NC 28204
Phone (704) 384-5043

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1481241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1881138873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043578",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1718 E 4th St",
            "address_2": "Suite 501",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282043261",
            "country_code": "US",
            "telephone_number": "704-347-2097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCANDONE",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-09",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5009159",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5009159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sscandone426282@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1718 E 4th St",
            "address_2": "Suite 501",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.