Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1023601069 Individual Practitioner Female Practitioner

Shannon Fultz , NP

Nurse Practitioner • Providence, RI

Professional Overview & Biography Verified Profile Summary

Shannon Fultz, NP is a registered healthcare professional specializing in Nurse Practitioner in Providence, RI. Practice services are available at 593 EDDY ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

593 Eddy St

Providence, RI 029034923

Telephone 4017939166
Fax 4014442788
Associated Practice Facility / Clinic
🏢 Rhode Island Hospital Facility NPI 1588659528

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Providence, RI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.4 Yrs
State Avg: 13.5 Yrs
Regional Practice Density
176 Specialists

Practicing in Providence, RI (397 Statewide)

Telehealth Adoption Rate
15.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-07-29
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License RI APRN02454

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Nurse Practitioner - Acute Care

NUCC Taxonomy Code: 363LA2100X

State License RI APRN02454

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID State
APRN02454 (RI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Eileen Wang , MD

Anesthesiology - Pain Medicine

NPI 1033642871

Doctor of Medicine (M.D.)

Lori Oliver , ANP-BC

Nurse Practitioner - Adult Health

NPI 1053662833

ANPBC

Dr. Elias Shaaya , MD

Neurological Surgery

NPI 1053840827

Doctor of Medicine (M.D.)

Dr. Ki-Eun Chang , MD

Neurological Surgery

NPI 1073979332

Doctor of Medicine (M.D.)

NPI 1083335301

Doctor of Nursing Practice, Advanced Practice Registered Nurse, Family Nurse Practitioner (Certified)

Dr. Belinda Shao , MD, MPH

Neurological Surgery

NPI 1104483353

Doctor of Medicine (M.D.), Master of Public Health

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location July 29, 2026

Registered at 593 EDDY ST, PROVIDENCE, RI 029034923 (Tel: 4017939166)

📍
Updated Business Mailing Address July 29, 2026

Registered at 15 LA SALLE SQ, PROVIDENCE, RI 029031814 (Tel: 4014446779)

👤
Provider Name / Credentials Updated July 29, 2026

Recorded as SHANNON FULTZ, NP

NPI Profile Active February 19, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location February 19, 2021

Registered at 3 MYRTLE AVE, RIVERSIDE, RI 029154733 (Tel: 6037651431)

📍
Updated Business Mailing Address February 19, 2021

Registered at 3 MYRTLE AVE, RIVERSIDE, RI 029154733

👤
Provider Name / Credentials Updated February 19, 2021

Recorded as SHANNON FULTZ, APRN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 19, 2021

Nurse Practitioner (License #APRN02454 in RI)

🟢
Initial NPI Registration & Enumeration February 19, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1023601069
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 19, 2021
Last Update: July 29, 2026
Sole Proprietor: No

Mailing Address

15 La Salle Sq

Providence, RI 029031814

Phone: 4014446779

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.