Shannon Morgan Mayville, APN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

A01383 ANP Issued in AR

Practice address

1201 E 9TH St
Bonham, TX 75418-4059

Phone

(903) 583-6320

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• QHG of Springdale, Inc.

  • Psychologist
  • Fayettevill, AR
  • NPI 1699796342
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1043322191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 E 9TH ST",
            "city": "BONHAM",
            "state": "TX",
            "postal_code": "754184059",
            "telephone_number": "903-583-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E 9TH ST",
            "city": "BONHAM",
            "state": "TX",
            "postal_code": "754184059",
            "telephone_number": "903-583-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYVILLE",
        "first_name": "SHANNON",
        "middle_name": "MORGAN",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AR",
            "license": "A01383 ANP",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1480",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clem C Martin, D.C.
• Gilbert Martinez, RT
• Sharon Maria Mathew, PHARMD
• Bonnie D Mauppin, PTA
• Maximum Care, Inc.
• Yolanda McCallister, MS, LCDC-I
• Jeffery Brice McGehee, OTR
• Annette McLemore, RN
• Melanie Hardy Aprn-BC PLLC
• Donald Arthur Mendelow, M.D.

• Gerontology Nurse Practitioner in Bonham, TX
• Providers in Bonham, TX by specialty
• Gerontology Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.