SHANNON PROFANCHIK
NPI 1376918862
Nurse Practitioner - Family in Coppell, TX
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
Specialties & Licenses
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).
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.
Other Providers at the Same Location NPPES 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
COPPELL, TX 75019
COPPELL, TX 75019
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 Profanchik's NPI number?
The NPI number for Shannon Profanchik is 1376918862. It was assigned to this individual provider in the NPPES registry on December 9, 2015.
Where is Shannon Profanchik located?
Shannon Profanchik practices at 546 E Sandy Lake Rd, Coppell, TX 75019. The listed phone number is (972) 393-8067.
What is Shannon Profanchik's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Shannon Profanchik enrolled in Medicare?
Yes. Shannon Profanchik is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Shannon Profanchik was last updated on December 9, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Shannon Profanchik · NPI 1376918862
Family physician in Coppell, Texas. Individual provider, active in the CMS NPPES registry since December 9, 2015.
## Identity
- **NPI:** 1376918862 (Entity type: Individual)
- **Enumerated:** December 9, 2015
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** AP129425 (Texas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 546 E SANDY LAKE RD, Coppell, TX 75019-5786
- **Phone:** (972) 393-8067
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** December 9, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1376918862) · Data from the CMS NPPES public registry.