MS. SHANNON R RUSSOM N.P.
NPI 1013948850
Nurse Practitioner - Family in Williston, VT

Active since July 06, 2006PECOS EnrolledAccepts Medicare Assignment
353 BLAIR PARK RD, WILLISTON, VT 05495(802) 847-1600(802) 847-7184 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Ms. Shannon R Russom N.p. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. SHANNON R RUSSOM N.P. (NPI 1013948850) is an individual family provider in Williston, Vermont, licensed in Vermont (1010017858) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with Champlain Valley Physicians Hospital Medical Ctr, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1013948850
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMS. SHANNON R RUSSOMCredential: N.P.
Location Address353 BLAIR PARK RDWilliston, VT 05495-7530
Mailing Address87 Carse RdHuntington, VT 05462-9550 · (802) 434-4195
Fax(802) 847-7184
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateJuly 6, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1013948850 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in VT · 1010017858
353 BLAIR PARK RD, Williston, VT 05495

Other Identifiers 6

Medicare ID-Type UnspecifiedNP3820VT · Vermont Medicare
Other6309101VT · Apex
Medicaid1008958VT
Other58796VT · Blue Shield
Other150268VT · Mvp
Medicare UPINP61822VT

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ms. Shannon R Russom N.p. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8022054568
PECOS Enrollment IDI20050706000527
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101
This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.
71 services71 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
42 services34 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Champlain Valley Physicians Hospital Medical Ctr

Acute Care Hospitals · Plattsburgh, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330250
Location75 Beekman StreetPlattsburgh, NY 12901 · Clinton County
Emergency services Birthing friendly

Univ. Of Vermont - Fletcher Allen Health Care

Acute Care Hospitals · Burlington, VT
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number470003
Location111 Colchester AveBurlington, VT 05401 · Chittenden County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 05495 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.89 typical visit price
range $55.80 – $168.48
Typical copayment $21.47 (range $13.95 – $42.12)
Most-billed visit code 99203
Established Patient
$98.40 typical visit price
range $18.08 – $137.84
Typical copayment $24.60 (range $4.52 – $34.46)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
353 BLAIR PARK RD
WILLISTON, VT 05495
Internal Medicine
353 BLAIR PARK RD
WILLISTON, VT 05495
Durable Medical Equipment & Medical Supplies
353 BLAIR PARK RD
WILLISTON, VT 05495
Pediatrics
353 BLAIR PARK RD
WILLISTON, VT 05495
Nurse Practitioner
353 BLAIR PARK RD
WILLISTON, VT 05495
Nurse Practitioner
353 BLAIR PARK RD
WILLISTON, VT 05495
Nurse Practitioner
353 BLAIR PARK RD
WILLISTON, VT 05495
Pediatrics
353 BLAIR PARK RD
WILLISTON, VT 05495

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Russom's NPI number?

The NPI number for Shannon Russom is 1013948850. It was assigned to this individual provider in the NPPES registry on July 6, 2006.

Where is Shannon Russom located?

Shannon Russom practices at 353 Blair Park Rd, Williston, VT 05495. The listed phone number is (802) 847-1600.

What is Shannon Russom's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shannon Russom enrolled in Medicare?

Yes. Shannon Russom is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shannon Russom accept?

Health plans from Anthem Blue Cross and Blue Shield list Shannon Russom as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Shannon Russom affiliated with any hospitals?

According to CMS data, Shannon Russom is affiliated with Champlain Valley Physicians Hospital Medical Ctr and Univ. Of Vermont - Fletcher Allen Health Care.

When was this NPI record last updated?

The NPPES record for Shannon Russom was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.