Active NPI
Sheyanne Chan, DNP, CPNP-PC, PMHS
- Pediatric Nurse Practitioner
- Fort Cavazos, TX
National Provider Identifier
1114287422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- AP116809
- Practice address
- 590 Medical Center Road
Fort Cavazos, TX 76544 - Phone
- (254) 553-5882
- NPI assigned
- May 21, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | 717639 | TX | |
| Pediatric Nurse Practitioner | 363LP0200X | AP116809 | TX | Primary |
Addresses
Primary practice location
590 Medical Center Road
Fort Cavazos, TX 76544
Mailing address
590 Medical Center Road
Fort Cavazos, TX 76544
Other practice location 1
301 University Blvd
Galveston, TX 77555-0351
Phone (409) 772-3695
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 |
|---|---|---|---|
| AP116809 | TX | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utmb Faculty Group Practice | Current | Accepting new patients |
Locations
301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883
Organizations & group practices 1
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.
-
- General Practice Physician
- Galveston, TX
- NPI 1942241146
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750118400000",
"number": "1114287422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "590 MEDICAL CENTER ROAD",
"city": "FORT CAVAZOS",
"state": "TX",
"postal_code": "76544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 MEDICAL CENTER ROAD",
"city": "FORT CAVAZOS",
"state": "TX",
"postal_code": "76544",
"telephone_number": "254-553-5882"
}
],
"practiceLocations": [
{
"address_1": "301 University Blvd",
"address_purpose": "LOCATION",
"city": "Galveston",
"state": "TX",
"postal_code": "775550351",
"country_code": "US",
"telephone_number": "409-772-3695",
"fax_number": "832-340-2350",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHAN",
"first_name": "SHEYANNE",
"credential": "DNP, CPNP-PC, PMHS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-21",
"last_updated": "2025-06-17",
"certification_date": "2025-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pediatrics",
"state": "TX",
"license": "717639",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "TX",
"license": "AP116809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Cavazos, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.