Shannon Danielle Fry, is a medicare enrolled "Physical Medicine & Rehabilitation" in Erie, Illinois. She graduated from nursing school in 2022 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. Her current practice location is
5789 Cordova Rd, Erie, Illinois. You can reach out to her office (for appointments etc.) via phone at
(863) 221-2351.
Shannon Danielle Fry is licensed to practice in Illinois (license number 209.025648) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1982335022.
Provider's Profile
| Full Name | Shannon Danielle Fry |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 4 Years |
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| Location | 5789 Cordova Rd, Erie, Illinois |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Shannon Danielle Fry graduated from nursing school in 2022
NPI Data:
- NPI Number: 1982335022
- Provider Enumeration Date: 06/20/2022
- Last Update Date: 12/30/2024
Medicare PECOS Information:
- PECOS PAC ID: 1951771013
- Enrollment ID: I20240319003513
Medical Identifiers
Medical identifiers for Shannon Danielle Fry such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1982335022 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 163WP0000X | Registered Nurse - Pain Management | 209.025648 (Illinois) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | A169408 (Iowa) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | 209.025648 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shannon Danielle Fry allows following entities to bill medicare on her behalf.
| Entity Name | Chestnut Health Of Illinois Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1588043939 PECOS PAC ID: 2264747344 Enrollment ID: O20150819006369 |
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| Entity Name | Quality Care Partners Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1114747060 PECOS PAC ID: 9436689106 Enrollment ID: O20250211000428 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shannon Danielle Fry is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Shannon Danielle Fry, 5789 Cordova Rd, Erie, IL 61250-9740 Ph: (863) 221-2351 | Shannon Danielle Fry, 5789 Cordova Rd, Erie, IL 61250-9740 Ph: (863) 221-2351 |
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