Shannon Brennan, NP
Individual provider Active NPI Family Nurse Practitioner · South Ogden, UT
NPI 1962869552 · NPPES record last updated Jan 27, 2016
Key facts
- NPI
- 1962869552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 283634-4405 (UT)
- Practice address
- 1525 E 6000 S
South Ogden, UT 84405-7144 - Phone
- (801) 337-5800
- NPI assigned
- Jan 27, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Circle of Life Inc
Practice addresses (Care Compare)
1525 E 6000
Suite a
Ogden, UT 84405-7149
Phone (801) 337-5800
Hospital & facility affiliations
- Intermountain Health McKay-Dee Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160315002914 | UT | Practitioner - Nurse Practitioner | 8729384870 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Circle of Life Inc | Current |
Accepting new patients |
Locations
1525 E 6000 S
South Ogden, UT 84405
Phone (801) 337-5800
1525 E 6000 S
Ste A
South Ogden, UT 84405
Phone (801) 337-5800
Interoperability endpoints
- mindfulmedical.shannonbrennan@156096.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 283634-4405 | UT | Yes |
Addresses
Primary practice location
1525 E 6000 S
South Ogden, UT 84405-7144
Mailing address
1525 E 6000 S
South Ogden, UT 84405-7144
Phone (801) 337-5800
Other providers in South Ogden, UT
- Tel Skidmore Boman
- Tamsyn Beyonce Bouwer
- Benton Mark Bramwell
- Kassandra Brandow
- Kelsey Braswell
- Bridge Medical Solutions LLC
- Bridge Physical Therapy LLC
- Brighton Recovery Center Intensive Outpatient LLC
- Brighton Recovery Center LLC
- Bringing Peace Counseling PLLC
All providers in South Ogden, UT · Family Nurse Practitioner in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.