Individual provider

Shannon Mcgourn, APRN

Family Nurse Practitioner Medicare enrolled

Shannon Mcgourn, APRN is a Family Nurse Practitioner in Waterbury, CT, registered under NPI 1104680644.

Getting there

The practice address on file is 1279 W MAIN ST, Waterbury, CT 06708. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

1279 W MAIN ST, Waterbury, CT 06708 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
F01241425 CT Family Nurse Practitioner primary

This provider holds licence F01241425 issued in CT. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Nurse Practitioner
PAC ID
6901393784
Enrollment ID
I20251015001193

Medicare enrolment is recorded as approved under the provider type Practitioner - Nurse Practitioner. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

What Family covers

Definition to come... NUCC Health Care Provider Taxonomy, code 363LF0000X
Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1104680644 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateFeb 6, 2024
Last updatedMar 11, 2026
StatusActive
Sole proprietorNo
CredentialAPRN
Practice address 1279 W MAIN ST
Waterbury, CT 06708
(203) 755-5490
Mailing address 785 OLD TURNPIKE RD
Plantsville, CT 06479
This record was updated on Mar 11, 2026, which is recent enough that the contact details are likely still accurate.

Number check

1104680644 passes the NPI check digit test The final digit 4 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 1 0 4 6 8 0 6 4
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 1 0 4 3 8 0 6 8

Sum = 56 · next multiple of 10 = 60 · check digit = 4 · actual last digit = 4

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1104680644?
NPI 1104680644 is the National Provider Identifier assigned to Shannon Mcgourn, APRN in Waterbury, CT. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Family cover?
Definition to come...
How do I contact Shannon Mcgourn, APRN?
The phone number on file with NPPES is (203) 755-5490, last updated Mar 11, 2026. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Shannon Mcgourn, APRN accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1104680644 a valid number?
Yes. 1104680644 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.