Individual provider Active NPI

Shana Beach, FNP-BC

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1093041477
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN14385 Issued in TN
Practice address
2018 Western Ave
Knoxville, TN 37921-5718
Phone
(865) 544-0406
Fax
(865) 544-0480
NPI assigned
Oct 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN0000014385 TN
Family Nurse Practitioner 363LF0000X APN14385 TN Primary
Registered Nurse 163W00000X RN169832 TN

Addresses

Primary practice location

2018 Western Ave
Knoxville, TN 37921-5718

Mailing address

6350 W Andrew Johnson Hwy
Department 100
Talbott, TN 37877-8605
Phone (800) 355-3565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20200520002595 DC Practitioner - Nurse Practitioner 4385785468 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN169832TNMDRegistered Nurse
APN0000014385TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Services of Holy Cross Nurse Practitioner CurrentSince Apr 1, 2020 Accepting new patients
Professional Services of Holy Cross CurrentSince Apr 1, 2020 Accepting new patients
Cherokee Health Systems Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

201 Russell Ave
Gaithersburg, MD 20877
Phone (301) 216-4157

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

Interoperability endpoints

  • Direct secure messaging: sbeach84801@direct.trinity-health.org

Organizations & group practices 4

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": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1093041477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6350 W ANDREW JOHNSON HWY",
            "address_2": "DEPARTMENT 100",
            "city": "TALBOTT",
            "state": "TN",
            "postal_code": "378778605",
            "telephone_number": "800-355-3565",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 WESTERN AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379215718",
            "telephone_number": "865-544-0406",
            "fax_number": "865-544-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEACH",
        "first_name": "SHANA",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN0000014385",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN14385",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN169832",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.