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HEATHER M SHANNON NP
NPI 1790775005
Nurse Practitioner - Women's Health in Fulton, NY

Active since October 27, 2005PECOS EnrolledAccepts Medicare Assignment
522 S 4TH ST STE 500, FULTON, NY 13069(315) 598-4740(315) 598-4728 Get Directions Write a Review

NPPES record last updated: September 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 10, 2025, Nov 23, 2021, Mar 20, 2019 (3 updates tracked since 2019).

About Heather M Shannon Np NPPES

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

HEATHER M SHANNON NP (NPI 1790775005) is an individual women's health provider in Fulton, New York, licensed in New York (00420826) and active in the NPI registry since October 2005. She is enrolled in Medicare PECOS, is affiliated with Oswego Hospital, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1790775005
Entity TypeIndividualFemale
Primary Taxonomy363LW0102X
Provider Legal NameHEATHER M SHANNONCredential: NP
Location Address522 S 4TH ST STE 500Fulton, NY 13069
Mailing Address239 Oneida StFulton, NY 13069-1228 · (315) 598-4715 · Fax (315) 598-4751
Phone(315) 598-4740
Fax(315) 598-4728
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateOctober 27, 2005
Last NPPES UpdateSeptember 10, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 10, 2025
✔ NPI 1790775005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Women's HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LW0102X
License✔ Licensed in NY · 00420826
Also ListedAdvanced Practice MidwifeTaxonomy 367A00000X · License F000678-1 (NY)

Other Identifiers 1

Medicaid02381762NY

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

Heather M Shannon Np 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 ID3274591128
PECOS Enrollment IDI20041227000160
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Oswego Hospital

Acute Care Hospitals · Oswego, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330218
Location110 West Sixth StreetOswego, NY 13126 · Oswego County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13069 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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 2

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

LISA J. SOUSOU P.A.
Physician Assistant
522 S 4TH ST STE 500
FULTON, NY 13069
Oswego County (315) 598-4740
SAMANTHA SHEGGRUD P.A.
Physician Assistant
522 S 4TH ST STE 500
FULTON, NY 13069
Oswego County (315) 598-4790

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 Heather Shannon's NPI number?

The NPI number for Heather Shannon is 1790775005. It was assigned to this individual provider in the NPPES registry on October 27, 2005.

Where is Heather Shannon located?

Heather Shannon practices at 522 S 4th St Ste 500, Fulton, NY 13069. The listed phone number is (315) 598-4740.

What is Heather Shannon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.

Is Heather Shannon enrolled in Medicare?

Yes. Heather Shannon 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.

Is Heather Shannon affiliated with any hospitals?

According to CMS data, Heather Shannon is affiliated with Oswego Hospital.

When was this NPI record last updated?

The NPPES record for Heather Shannon was last updated on September 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.