MS. SHANNON R RUSSOM (N.P.) – Family Nurse Practitioner, NPI 1013948850

MS. SHANNON R RUSSOM (N.P.) is a healthcare provider. based in Huntington, Vermont. specializing in NURSE PRACTITIONER. They hold the professional credentials N.P.. They hold a License No. 1010017858 (VT). The NPI Number for MS. SHANNON R RUSSOM (N.P.) is 1013948850

Main info

Female
27 Years Of Experience
Accepts Medicare Assignment
Name
MS. SHANNON R RUSSOM (N.P.)
NPI
1013948850
Phone
(802) 434-4195
Address
87 CARSE RD
Enumeration Date
6 July 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8028470000
Graduation Year
1999 (27 years ago)
PAC ID
8022054568
Group Practice PAC ID
3779491071
Professional Enrollment ID
I20050706000527
Address ID
VT054011473BU111XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

721 NURSE PRACTITIONER in VT

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Provider Addresses for MS. SHANNON R RUSSOM (N.P.)

  • 87, Carse Road, Hanksville, Huntington, Chittenden County, Vermont, United States

    HUNTINGTON, VT 054629550

    Phone: (802) 434-4195

    Type: Mailing

  • 353, Blair Park Road, Tafts Corner, Williston, Chittenden County, Vermont, 05495, United States

    WILLISTON, VT 054957530

    Phone: (802) 847-1600

    Fax: (802) 847-7184

    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: 2005-07-06

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
I20050706000527INurse PractitionerVTTBD

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
G0101Cervical or vaginal cancer screening; pelvic and clinical breast examination8484$0
99213Established patient office or other outpatient visit, 20-29 minutes4736$0
View full utilization report →

Insurance plans in this area (ZIP 05462)

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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: 3779491071View full group profile

Reviews

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Frequently asked questions

What identifier follows MS. SHANNON R RUSSOM (N.P.) across health systems?
The NPI 1013948850 uniquely identifies MS. SHANNON R RUSSOM (N.P.) in U.S. healthcare data.
Quick check: is MS. SHANNON R RUSSOM (N.P.) active?
Public NPPES data shows MS. SHANNON R RUSSOM (N.P.) with an active NPI status right now.
Which specialty label fits MS. SHANNON R RUSSOM (N.P.)?
NPPES ties MS. SHANNON R RUSSOM (N.P.) to Family Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to MS. SHANNON R RUSSOM (N.P.)?
The directory associates MS. SHANNON R RUSSOM (N.P.) with Huntington, Vermont. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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