Active NPI
Shannon Runk
- Social Worker
- Owings Mills, MD
National Provider Identifier
1891367876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 24945
- Practice address
- 9199 Reisterstown Rd
Owings Mills, MD 21117-4520 - Phone
- (443) 895-2366
- NPI assigned
- Jul 11, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 24945 | MD | Primary |
Addresses
Primary practice location
9199 Reisterstown Rd
Owings Mills, MD 21117-4520
Mailing address
2509 Monarch Way
Bel Air, MD 21015-6079
Phone (443) 895-2366
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 4, 2024 through Jun 4, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24945 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625961600000",
"number": "1891367876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2509 MONARCH WAY",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210156079",
"telephone_number": "443-895-2366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9199 REISTERSTOWN RD",
"city": "OWINGS MILLS",
"state": "MD",
"postal_code": "211174520",
"telephone_number": "443-895-2366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUNK",
"first_name": "SHANNON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-11",
"last_updated": "2021-07-11",
"certification_date": "2021-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "24945",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Owings Mills, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.