Look up the most recent NPI and PECOS records

Shannon Tara Ormsbee

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

Wamc Clark Health Clinic, Bldg 5-4257 Bastogne Street, Fort Bragg, NC 28310

PECOS Enrollment

This provider is enrolled in PECOS as SHANNON ORMSBEE.

Based on the most recent information from CMS, provider Shannon Tara Ormsbee 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 today at 9:43 AM.

Profile Details

Provider ID
1972856706
Provider Type
Individual
Full Name
Ormsbee, Shannon Tara
Title
Mrs.
Credential
APRN

Gender
Female
Sole Proprietor
No
Enumeration Date
10/17/2012
Last Updated
5/8/2019

Contact Information

Practice Location

Wamc Clark Health Clinic, Bldg 5-4257 Bastogne Street, Fort Bragg, NC 28310

(910) 907-2575

(910) 908-7738

Mailing Location

209 Timberlake Drive, Fayetteville, NC 28314

(802) 779-7128

(910) 908-7738

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 5009248 North Carolina
Code 363LF0000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 005158 Connecticut

Shannon Tara Ormsbee

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provence, Sunny

Casas, Bobbi J

Kim, Emily D

Boatright, Ashley Nichole

Stover, Jerry Boyd

Brunson, Shareeka Lateea

Roumell, Nikolas John

Wearins, Stephanie L.

Lutzen, Carrie E

Wilhelm, Amanda