SHANNON SUMMER PEMBERTON PMHNP
NPI 1346958279
Nurse Practitioner - Psychiatric/Mental Health in Barboursville, WV

Q: What is Shannon Pemberton's NPI number?

The NPI number for Shannon Pemberton is 1346958279. It was assigned to this individual provider in the NPPES registry on November 9, 2022.

Q: What is Shannon Pemberton's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Pemberton was last updated on June 18, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since November 09, 2022PECOS EnrolledAccepts Medicare Assignment

6171 CHILDERS RD, BARBOURSVILLE, WV 25504(304) 733-5380 Get Directions Write a Review

NPPES record last updated: June 18, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Shannon Summer Pemberton Pmhnp NPPES

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

SHANNON SUMMER PEMBERTON PMHNP (NPI 1346958279) is an individual psychiatric/mental health provider in Barboursville, West Virginia, licensed in Kentucky (3018645) and active in the NPI registry since November 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1346958279

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameSHANNON SUMMER PEMBERTONCredential: PMHNP

Location Address6171 CHILDERS RDBarboursville, WV 25504-1227

Mailing Address52 Childers RdBarboursville, WV 25504-7683 · (304) 733-5380

Phone(304) 733-5380

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateNovember 9, 2022

Last NPPES UpdateJune 18, 2026

NPPES CertifiedJune 18, 2026

✔ NPI 1346958279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in KY · 3018645

6171 CHILDERS RD, Barboursville, WV 25504

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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

Shannon Summer Pemberton Pmhnp 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 ID3173994449

PECOS Enrollment IDI20260506001228

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 3

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.

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.

94 services46 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

82 services48 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

55 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25504 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

$83.49 typical visit price

range $53.20 – $164.59

Typical copayment $20.87 (range $13.30 – $41.14)

Most-billed visit code 99203

Established Patient

$94.81 typical visit price

range $16.47 – $133.29

Typical copayment $23.70 (range $4.11 – $33.32)

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.

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Other Providers at the Same Location NPPES 6

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

TYLER R BURNS MA, LPC, AADC, NCC

Counselor (Professional)