SHANNON NOELLE PLANTENBERG (NP) – Nurse Practitioner, NPI 1891524435

SHANNON NOELLE PLANTENBERG (NP) is a healthcare provider. based in Bloomington, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 11992 (MN). The NPI Number for SHANNON NOELLE PLANTENBERG (NP) is 1891524435

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
SHANNON NOELLE PLANTENBERG (NP)
NPI
1891524435
Phone
Not provided
Address
8170 33RD AVE S # MS 21110Q
Enumeration Date
31 July 2024
Last Update Date
18 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9529934300
Graduation Year
2024 (2 years ago)
PAC ID
7012449630
Group Practice PAC ID
7911819438
Professional Enrollment ID
I20241021000832
Address ID
MN553179302CH300XXEXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness85
Years active:1State licenses:2Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for SHANNON NOELLE PLANTENBERG (NP)

  • 8170 33RD AVE S # MS 21110Q

    BLOOMINGTON, MN 554254516

    Phone:

    Type: Mailing

  • 3850 PARK NICOLLET BLVD

    SAINT LOUIS PARK, MN 554162527

    Phone: (952) 993-3400

    Type: Location

  • 10981 4th St NE Ste 104

    Hanover, MN 553414092

    Phone: (763) 733-1242

    Fax: (612) 484-4583

    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: 2024-10-21

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
I20241021000832INurse PractitionerMNTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55425)

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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: 7911819438View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YMN
Family PracticeMN
-MN
Pulmonary Disease, Critical Care (Intensivists), Internal MedicineMN
Cardiac ElectrophysiologyMN
Family PracticeMN
Physician AssistantMN
Physical Therapist In Private PracticeMN
Physician AssistantMN
D E R M A T O L O G YMN

Reviews

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Frequently asked questions

Can I cross-check SHANNON NOELLE PLANTENBERG (NP) using NPI 1891524435?
NPI 1891524435 belongs to SHANNON NOELLE PLANTENBERG (NP); compare other details if you need extra assurance.
Is there an active status for SHANNON NOELLE PLANTENBERG (NP)?
For scheduling context, SHANNON NOELLE PLANTENBERG (NP) is shown as active in the registry.
How would a patient describe SHANNON NOELLE PLANTENBERG (NP)'s focus?
For SHANNON NOELLE PLANTENBERG (NP), the primary taxonomy reads as Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Minnesota is SHANNON NOELLE PLANTENBERG (NP) registered?
Use Bloomington, Minnesota as the headline location for SHANNON NOELLE PLANTENBERG (NP) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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