NPIMap

Individual provider Active NPI

Shannon Nicole Biesterfeld, CRNM

  • Advanced Practice Midwife
  • Salisbury, MD
National Provider Identifier
1972062891
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
R250339 Issued in MD
Practice address
1647 Woodbrooke Dr
Salisbury, MD 21804-8502
Phone
(410) 546-2424
Fax
(410) 742-6633
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X R250339 MD Primary

Addresses

Primary practice location

1647 Woodbrooke Dr
Salisbury, MD 21804-8502

Mailing address

PO Box 1978
Salisbury, MD 21802-1978
Phone (410) 749-1015

Other identifiers 1

IdentifierTypeStateIssuer
119591300MedicaidMD

Other names 1

  • Ms. Shannon Nicole Edwards Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20190520001913 MD Practitioner - Certified Nurse Midwife (CNM) 8729321567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Three Lower Counties Community Services IncGroup PAC ID 3678484300, 74 clinicians

Practice addresses (Care Compare)

12137 Elm St
Princess Anne, MD 21853-1358
Phone (410) 651-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Three Lower Counties Community Services, Inc. CurrentSince May 20, 2019 Accepting new patients
Three Lower Counties Community Services, Inc. CurrentSince May 20, 2019 Accepting new patients
Three Lower Counties Community Services Inc Current Accepting new patients
Three Lower Counties Community Services, Inc. Past Accepting new patients

Locations

12145 Elm St
Princess Anne, MD 21853
Phone (410) 651-2204

12137 Elm St
Princess Anne, MD 21853
Phone (410) 651-1000

1647 Woodbrooke Dr
Salisbury, MD 21804
Phone (410) 546-2424

Interoperability endpoints

  • Direct secure messaging: shannon.biesterfeld.1@3167.direct.athenahealth.com

Organizations & group practices 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1972062891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218021978",
            "telephone_number": "410-749-1015",
            "fax_number": "410-749-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1647 WOODBROOKE DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218048502",
            "telephone_number": "410-546-2424",
            "fax_number": "410-742-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIESTERFELD",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "CRNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MD",
            "license": "R250339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "EDWARDS",
            "middle_name": "NICOLE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.