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

Shannon Grose, NP

Individual provider Nurse Practitioner · NPI 1629552799

Shannon Grose, NP is a Nurse Practitioner in Charleston, West Virginia. Qualified in 2018, 8 years ago. Practices with Cabin Creek Health Center Inc, a 45-clinician group and accepts Medicare assignment. Licensed in Maine and West Virginia.

Years since qualifying
8
Licensed in
ME, WV
In the registry since
2018
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

4602 Maccorkle Ave SE
Charleston, WV 25304-1848
Phone: (304) 205-7535
Fax: (304) 205-7549
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 114025 (WV)
Nurse Practitioner Taxonomy 363L00000X · Licence CNP181231 (ME)

Record details

NPI number1629552799
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedSeptember 24, 2018
Last updated in NPPESJune 14, 2023
Certification dateJune 14, 2023

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 Cabin Creek Health Center Inc — 45 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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