SHANNON MOEGGENBORG (APRN, FNP-C) – Family Nurse Practitioner, NPI 1528467669

SHANNON MOEGGENBORG (APRN, FNP-C) is a healthcare provider. based in Traverse city, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN, FNP-C. They hold a License No. 4704265833 (MI). The NPI Number for SHANNON MOEGGENBORG (APRN, FNP-C) is 1528467669

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
SHANNON MOEGGENBORG (APRN, FNP-C)
NPI
1528467669
Phone
(231) 947-0673
Address
4624 N SPIDER LAKE RD
Enumeration Date
14 August 2014
Last Update Date
26 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2315474024
Graduation Year
2014 (12 years ago)
PAC ID
6507810835
Group Practice PAC ID
6800241050
Professional Enrollment ID
I20150507000254
Address ID
MI497201931CH14700DRXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:11State licenses:1Digital endpointsOther names

8,106 NURSE PRACTITIONER in MI

Provider Addresses for SHANNON MOEGGENBORG (APRN, FNP-C)

  • 4624 N SPIDER LAKE RD

    TRAVERSE CITY, MI 496968440

    Phone: (231) 947-0673

    Fax: (801) 740-2847

    Type: Mailing

  • 1105 SIXTH ST

    TRAVERSE CITY, MI 496842349

    Phone: (231) 947-0673

    Fax: (801) 740-2847

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-05-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150507000254INurse PractitionerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only4530$0
99285Emergency department visit with high level of medical decision making3939$0
99284Emergency department visit with moderate level of medical decision making2928$0
99283Emergency department visit with low level of medical decision making1515$0
View full utilization report →

Insurance plans in this area (ZIP 49696)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6800241050View full group profile
NameSpecialtyState
Emergency Medicine, Hospice/Palliative Care, Internal Medicine, Pediatric MedicineMI
Emergency MedicineMI
Emergency MedicineMI
Nurse PractitionerMI
Emergency MedicineMI
Emergency MedicineIL
Emergency MedicineRI
Emergency MedicineMI
Emergency MedicineMI
Nurse PractitionerSD

Reviews

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Frequently asked questions

What is the 10-digit NPI for SHANNON MOEGGENBORG (APRN, FNP-C)?
SHANNON MOEGGENBORG (APRN, FNP-C) — NPI 1528467669 — is the standard way to identify this listing.
Does CMS list SHANNON MOEGGENBORG (APRN, FNP-C) as active?
Yes — SHANNON MOEGGENBORG (APRN, FNP-C) is active in the NPI listing used on this page.
What is SHANNON MOEGGENBORG (APRN, FNP-C)'s primary classification?
Family Nurse Practitioner is the headline specialty for SHANNON MOEGGENBORG (APRN, FNP-C) here. Clinical services aligned with this taxonomy classification.
Where should I expect SHANNON MOEGGENBORG (APRN, FNP-C) on a map?
Expect Traverse City, Michigan as a primary anchor for SHANNON MOEGGENBORG (APRN, FNP-C) unless the record lists multiple sites.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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