Individual provider Active NPI

Shana Danielle Robertson, RN, FNP-BC

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1114620341
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
37767 Issued in TN
Practice address
360 E Eh Crump Blvd
Memphis, TN 38126-5394
Phone
(901) 261-2000
NPI assigned
Mar 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 907057 MS
Family Nurse Practitioner 363LF0000X 37767 TN Primary
Neonatal Intensive Care Registered Nurse 163WN0002X 910621 MS

Addresses

Primary practice location

360 E Eh Crump Blvd
Memphis, TN 38126-5394

Mailing address

360 E Eh Crump Blvd
Memphis, TN 38126-5394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20250428001511 TN Practitioner - Nurse Practitioner 4486170008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Memphis Health Center, Inc.Group PAC ID 7315859972, 17 clinicians

Practice addresses (Care Compare)

360 E Eh Crump Blvd
Memphis, TN 38126-5310
Phone (901) 261-2025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
910621MSMDNeonatal Intensive Care Registered Nurse
907057MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memphis Health Center, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Memphis Health Center, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Memphis Health Center, Inc. Current Accepting new patients

Locations

360 E Eh Crump Blvd
Memphis, TN 38126
Phone (901) 261-2000

4593 Elvis Presley Blvd
Ste 101
Memphis, TN 38116
Phone (901) 261-2000

4940 Highway 57
Ste 107
Rossville, TN 38066
Phone (901) 261-2221

4940 Highway 57
Rossville, TN 38066
Phone (901) 261-2221

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1114620341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 E EH CRUMP BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381265394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E EH CRUMP BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381265394",
            "telephone_number": "901-261-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "SHANA",
        "middle_name": "DANIELLE",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "907057",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "37767",
            "primary": true
        },
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "MS",
            "license": "910621",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.