Individual provider Active NPI

Shannon L Williams, AU.D.

  • Audiologist-Hearing Aid Fitter
  • Plano, TX
National Provider Identifier
1003077017
Registry record updated Nov 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
51712 Issued in TX
Practice address
6509 W Plano Pkwy
Plano, TX 75093-8209
Phone
(972) 781-1462
Fax
(972) 378-4125
NPI assigned
Jun 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 51712 TX Primary

Addresses

Primary practice location

6509 W Plano Pkwy
Plano, TX 75093-8209

Mailing address

6509 W Plano Pkwy
Plano, TX 75093-8209
Phone (972) 781-1462

Other identifiers 1

IdentifierTypeStateIssuer
1470180MedicaidLA

Other names 1

  • Ms. Shannon L Jette Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090312000637 TX Practitioner - Qualified Audiologist 4688634363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Ear Nose and Throat Associates, PAGroup PAC ID 2264496769, 2 clinicians

Practice addresses (Care Compare)

6509 W Plano Pkwy
Plano, TX 75093-8209
Phone (972) 781-1462

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5312LAMDProfessional Counselor
51712TXMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Ear Nose and Throat Associates, PA CurrentSince Jan 10, 2017 Accepting new patients
Metro Ear Nose and Throat Associates, PA CurrentSince Jan 10, 2017 Accepting new patients
Huguley Medical Associates PastSince Nov 1, 2024 Accepting new patients

Locations

900 Jerome St
Ste 200
Fort Worth, TX 76104
Phone (682) 268-6705

6509 W Plano Pkwy
Plano, TX 75093
Phone (800) 693-6732

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509580800000",
    "number": "1003077017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6509 W PLANO PKWY",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938209",
            "telephone_number": "972-781-1462",
            "fax_number": "972-378-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6509 W PLANO PKWY",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938209",
            "telephone_number": "972-781-1462",
            "fax_number": "972-378-4125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHANNON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2017-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TX",
            "license": "51712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1470180",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "JETTE",
            "middle_name": "L",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.