Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shannon Gail Stark, MACCC/SLP, NP-C

Individual provider Speech-Language Pathologist · NPI 1003129438

Shannon Gail Stark, MACCC/SLP, NP-C is a Nurse Practitioner in Sidney, New York. Qualified in 2018, 8 years ago. Practices with Mary Imogene Bassett Hospital, a 779-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
8
Licensed in
NY
In the registry since
2010
Specialties on file
2
What do these letters mean?
NP-C — Nurse Practitioner, Certified
A nurse practitioner certified by the AANP.

See every abbreviation used in this directory →

Practice location Address checks out

39 Pearl St W
Sidney, NY 13838
Phone: (607) 561-2021
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 31 Park Ter W, New York, NY 10034-1514 — (212) 927-9706

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 343815 (NY)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 0106541 (NY)

Record details

NPI number1003129438
Entity typeIndividual (Type 1)
GenderFemale
Credentials MACCC/SLP , NP-C
Sole proprietorNo
NPI enumeratedJuly 14, 2010
Last updated in NPPESFebruary 4, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Mary Imogene Bassett Hospital — 779 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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