MRS. SHANNON MARIE MCGOURN APRN
NPI 1104680644
Nurse Practitioner - Family in Waterbury, CT
About Mrs. Shannon Marie Mcgourn Aprn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. SHANNON MARIE MCGOURN APRN (NPI 1104680644) is an individual family provider in Waterbury, Connecticut, licensed in Connecticut (F01241425) and active in the NPI registry since February 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Shannon Marie Mcgourn Aprn 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.
Medicare Billing Reassignments
3Medicare enrollment records show Shannon Mcgourn reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Waterbury, CT 06702
- Reassigned Medicare billing, Connecticut enrollment
- 97 clinicians in this Medicare group
Rocky Hill, CT 06067
- Reassigned Medicare billing, Connecticut enrollment
- 62 clinicians in this Medicare group
Rocky Hill, CT 06067
- Reassigned Medicare billing, Connecticut enrollment
- 124 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 06708 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 14
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Mcgourn's NPI number?
The NPI number for Shannon Mcgourn is 1104680644. It was assigned to this individual provider in the NPPES registry on February 6, 2024.
Where is Shannon Mcgourn located?
Shannon Mcgourn practices at 1279 W Main St, Waterbury, CT 06708. The listed phone number is (203) 755-5490.
What is Shannon Mcgourn's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Shannon Mcgourn enrolled in Medicare?
Yes. Shannon Mcgourn 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.
Which organizations bill Medicare for Shannon Mcgourn's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shannon Mcgourn reassigns Medicare benefits to 3 organizations: Staywell Health Care, Inc. (Waterbury, CT), Minuteclinic Primary Care Connecticut PLLC (Rocky Hill, CT) and Mc Diagnostic Of Connecticut, P.C. (Rocky Hill, CT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shannon Mcgourn's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Shannon Mcgourn accept?
Health plans from Anthem Blue Cross and Blue Shield list Shannon Mcgourn 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.
When was this NPI record last updated?
The NPPES record for Shannon Mcgourn was last updated on March 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Mrs. Shannon Marie Mcgourn, APRN · NPI 1104680644
Family physician in Waterbury, Connecticut. Individual provider, active in the CMS NPPES registry since February 6, 2024.
## Identity
- **NPI:** 1104680644 (Entity type: Individual)
- **Enumerated:** February 6, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** F01241425 (Connecticut)
- **Sole proprietor:** No
## Practice location
- **Address:** 1279 W MAIN ST, Waterbury, CT 06708-3101
- **Phone:** (203) 755-5490
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Staywell Health Care, Inc. (NPI 1154342335, Waterbury, CT); Minuteclinic Primary Care Connecticut PLLC (NPI 1548076086, Rocky Hill, CT); Mc Diagnostic Of Connecticut, P.C. (NPI 1386821932, Rocky Hill, CT) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** March 11, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1104680644) · Data from the CMS NPPES public registry.