Active NPI
Shannon McMahon, APRN
- Psychiatric/Mental Health Nurse Practitioner
- Austin, TX
National Provider Identifier
1033532932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- AP124880
- Practice address
- 7112 Ed Bluestein Blvd Ste 100
Austin, TX 78723-2913 - Phone
- (512) 744-6000
- Fax
- (512) 583-0440
- NPI assigned
- Jan 28, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 752993 | TX | |
| Family Nurse Practitioner | 363LF0000X | AP124880 | TX | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP124880 | TX | Primary |
Addresses
Primary practice location
7112 Ed Bluestein Blvd Ste 100
Austin, TX 78723-2913
Mailing address
9411 N Lamar Blvd Ste 120
Austin, TX 78753-4179
Phone (512) 583-9679
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3354680-02 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 752993 | TX | MD | Registered Nurse |
| AP124880 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Texas Community Health Centers | Family | Current | Accepting new patients |
| Central Texas Community Health Centers | Current | Accepting new patients |
Locations
2237 E Riverside Dr
Ste 101C
Austin, TX 78741
7112 Ed Bluestein Blvd
Ste 100
Austin, TX 78723
9411 N Lamar Blvd
Ste 120
Austin, TX 78753
Phone (512) 583-9679
1221 W Ben White Blvd
Ste 200B
Austin, TX 78704
Phone (512) 524-9249
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Austin, TX
- NPI 1427882091
-
- Federally Qualified Health Center (FQHC)
- Austin, TX
- NPI 1598591414
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728000000000",
"number": "1033532932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9411 N LAMAR BLVD STE 120",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787534179",
"telephone_number": "512-583-9679",
"fax_number": "512-233-0985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7112 ED BLUESTEIN BLVD STE 100",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787232913",
"telephone_number": "512-744-6000",
"fax_number": "512-583-0440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMAHON",
"first_name": "SHANNON",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-28",
"last_updated": "2024-10-04",
"certification_date": "2024-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TX",
"license": "752993",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "AP124880",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "TX",
"license": "AP124880",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3354680-02",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.