Look up the most recent NPI and PECOS records

Shannon Kathleen Burns

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

PECOS Enrollment

This provider is enrolled in PECOS as SHANNON BURNS.

Based on the most recent information from CMS, provider Shannon Kathleen Burns is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1003258898
Provider Type
Individual
Full Name
Burns, Shannon Kathleen
Credential
ARNP

Gender
Female
Sole Proprietor
No
Enumeration Date
7/23/2013
Last Updated
1/23/2023

Contact Information

Practice Location

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

Unlisted Fax

Mailing Location

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License ARNP9296168 Florida
Code 363LA2200X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License ARNP9296168 Florida

Provider Identifiers

ID	Description	Issuer
ID 00935000	Description Medicaid	Issuer Unlisted Florida

Shannon Kathleen Burns

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Chang, Anna Y

Reynolds, Gina

Carmon, Stephanie Victoria

Nobles, Daniel

Matos, Nikki

Romecki, Bree Z Brasch

Neeson, Lynn

Gaouette, Sally Anne

Arntson-Morgan, Kathleen Carol

Moreno-Lackman, Andrea