MRS. SHANNON FULTZ NP
NPI 1023601069
Nurse Practitioner in Providence, RI

Q: What is Shannon Fultz's NPI number?

The NPI number for Shannon Fultz is 1023601069. It was assigned to this individual provider in the NPPES registry on February 19, 2021. The provider is also known as Shannon Gill.

Q: What is Shannon Fultz's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Fultz was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.

Active since February 19, 2021PECOS Enrolled

593 EDDY ST, PROVIDENCE, RI 02903(401) 793-9166(401) 444-2788 Get Directions Write a Review

NPPES record last updated: July 29, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Jul 29, 2026, Feb 19, 2021 (2 updates tracked since 2021).

On this page

About Mrs. Shannon Fultz Np NPPES

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

MRS. SHANNON FULTZ NP (NPI 1023601069) is an individual nurse practitioner in Providence, Rhode Island, licensed in Rhode Island (APRN02454) and active in the NPI registry since February 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023601069

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMRS. SHANNON FULTZCredential: NP

Location Address593 EDDY STProvidence, RI 02903-4923

Mailing Address15 La Salle SqProvidence, RI 02903-1814 · (401) 444-6779 · Fax (401) 444-6912

Phone(401) 793-9166

Fax(401) 444-2788

Sole ProprietorNo

Enumeration DateFebruary 19, 2021

Last NPPES UpdateJuly 29, 20262 updates tracked since enumeration

NPPES CertifiedJuly 29, 2026

✔ NPI 1023601069 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in RI · APRN02454

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X · License APRN02454 (RI)

593 EDDY ST, Providence, RI 02903

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Other Names 1

Former Name (1)Shannon Gill

Other Identifiers 1

OtherAPRN02454RI · State

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Shannon Fultz Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02903 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

$90.48 typical visit price

range $58.57 – $177.03

Typical copayment $22.62 (range $14.64 – $44.25)

Most-billed visit code 99203

Established Patient

$103.10 typical visit price

range $18.92 – $144.38

Typical copayment $25.77 (range $4.73 – $36.09)

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.

DR. KEITH-AUSTIN SCARFO D.O.

Anesthesiology

593 EDDY ST, APC 6
PROVIDENCE, RI 02903

Providence County (401) 444-3777

AILEEN HSUEH

Surgery

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-8450

RHODE ISLAND HOSPITAL

General Acute Care Hospital

593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903

Providence County (401) 444-7585

DR. GA HIE NAM M.D.

Pathology (Anatomic Pathology & Clinical Pathology)

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-5057

EUGENIE ATALLAH

Psychiatry & Neurology (Neurology)

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 606-2645

BRET CAULFIELD

Physician Assistant

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-4000

JUNG HO GONG

Student in an Organized Health Care Education/Training Program

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 793-2695

FANNY HUANG MD

Student in an Organized Health Care Education/Training Program

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-4741

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 Fultz's NPI number?

The NPI number for Shannon Fultz is 1023601069. It was assigned to this individual provider in the NPPES registry on February 19, 2021. The provider is also known as Shannon Gill.

Where is Shannon Fultz located?

Shannon Fultz practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 793-9166.

What is Shannon Fultz's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Shannon Fultz enrolled in Medicare?

Yes. Shannon Fultz is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shannon Fultz was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.