KELLEY KOMETA SHANNON RN
NPI 1669266219
Nurse Practitioner - Psychiatric/Mental Health in Allentown, PA

Q: What is Kelley Shannon's NPI number?

The NPI number for Kelley Shannon is 1669266219. It was assigned to this individual provider in the NPPES registry on April 8, 2025. The provider is also known as Kelley Kometa.

Q: What is Kelley Shannon'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 Kelley Shannon was last updated on July 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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 April 08, 2025PECOS EnrolledAccepts Medicare Assignment

1259 S CEDAR CREST BLVD STE 230, ALLENTOWN, PA 18103(610) 402-5900(610) 402-4650 Get Directions Write a Review

NPPES record last updated: July 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 4, 2025, Apr 8, 2025 (2 updates tracked since 2025).

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About Kelley Kometa Shannon Rn NPPES

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

KELLEY KOMETA SHANNON RN (NPI 1669266219) is an individual psychiatric/mental health provider in Allentown, Pennsylvania, licensed in Pennsylvania (SP032895) and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1669266219

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameKELLEY KOMETA SHANNONCredential: RN

Location Address1259 S CEDAR CREST BLVD STE 230Allentown, PA 18103-6376

Mailing Address2100 Mack Blvd Fl 4Allentown, PA 18103-5622 · (484) 884-4500 · Fax (484) 884-0699

Phone(610) 402-5900

Fax(610) 402-4650

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateApril 8, 2025

Last NPPES UpdateJuly 30, 20252 updates tracked since enumeration

NPPES CertifiedJuly 30, 2025

✔ NPI 1669266219 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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

Taxonomy Code363LP0808X

License✔ Licensed in PA · SP032895

Also ListedRegistered NurseTaxonomy 163W00000X · License RN663117 (PA)

1259 S CEDAR CREST BLVD STE 230, Allentown, PA 18103

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Other Names 1

Former Name (1)Kelley Kometa

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

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

Kelley Kometa Shannon Rn 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 ID8921509480

PECOS Enrollment IDI20250827004140

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 18103 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

$84.88 typical visit price

range $54.64 – $166.87

Typical copayment $21.22 (range $13.66 – $41.71)

Most-billed visit code 99203

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

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.

MR. JOSUE A PIMENTEL DIAZ PMHNP CRNP

Nurse Practitioner (Psychiatric/Mental Health)