Individual provider Active NPI

Debra Lynn Shearon, FNP-C

  • Family Nurse Practitioner
  • Granbury, TX
National Provider Identifier
1033743802
Registry record updated Dec 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP145301 Issued in TX
Practice address
3605 Pecan Arbor CT
Granbury, TX 76049
Phone
(817) 578-1667
NPI assigned
Mar 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP145301 TX Primary

Addresses

Primary practice location

3605 Pecan Arbor CT
Granbury, TX 76049

Mailing address

3605 Pecan Arbor CT
Granbury, TX 76049
Phone (817) 578-1667

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200810003191 TX Order and Referring Only - Nurse Practitioner 6406271220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP145301TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639267200000",
    "number": "1033743802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 PECAN ARBOR CT",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "76049",
            "telephone_number": "817-578-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 PECAN ARBOR CT",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "76049",
            "telephone_number": "817-578-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARON",
        "first_name": "DEBRA",
        "middle_name": "LYNN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-02",
        "last_updated": "2021-12-12",
        "certification_date": "2021-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP145301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

Verify at the official NPI Registry.