SHANNON PROFANCHIK
NPI 1376918862
Nurse Practitioner - Family in Coppell, TX

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

Active since December 09, 2015PECOS Enrolled

546 E SANDY LAKE RD, COPPELL, TX 75019(972) 393-8067 Get Directions Write a Review

NPPES record last updated: December 9, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Shannon Profanchik NPPES

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

SHANNON PROFANCHIK (NPI 1376918862) is an individual family provider in Coppell, Texas, licensed in Texas (AP129425) and active in the NPI registry since December 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376918862

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSHANNON PROFANCHIK

Location Address546 E SANDY LAKE RDCoppell, TX 75019-5786

Mailing Address546 E Sandy Lake RdCoppell, TX 75019-5786 · (972) 393-8067

Phone(972) 393-8067

Sole ProprietorYes

Enumeration DateDecember 9, 2015

✔ NPI 1376918862 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 TX · AP129425

546 E SANDY LAKE RD, Coppell, TX 75019

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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 (PECOS)

Shannon Profanchik 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 75019 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

$88.19 typical visit price

range $57.18 – $172.86

Typical copayment $22.04 (range $14.29 – $43.21)

Most-billed visit code 99203

Established Patient

$100.80 typical visit price

range $18.48 – $141.20

Typical copayment $25.20 (range $4.62 – $35.30)

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.