Individual provider Active NPI

Shannon N Amacker, FNP

  • Family Nurse Practitioner
  • Clinton, LA
National Provider Identifier
1154646388
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP05954 Issued in LA
Practice address
11990 Jackson St
Clinton, LA 70722-3210
Phone
(225) 683-5292
Fax
(225) 683-1310
NPI assigned
Mar 31, 2010
Last updated
Feb 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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 AP05954 LA Primary

Addresses

Primary practice location

11990 Jackson St
Clinton, LA 70722-3210

Mailing address

PO Box 395
Clinton, LA 70722-0395
Phone (225) 683-5292

Other identifiers 1

IdentifierTypeStateIssuer
2143671MedicaidLA

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
I20220523000530 TX Practitioner - Nurse Practitioner 0648457770 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vohra Post Acute Care Physicians of Texas, PLLCGroup PAC ID 0042447682, 41 clinicians

Practice addresses (Care Compare)

11169 Sean Haggerty Dr
El Paso, TX 79934-3385
Phone (915) 849-3000

11490 Gateway Blvd N
El Paso, TX 79934-3456
Phone (915) 317-1758

1201 Clarks Dr
Abilene, TX 79602-3146
Phone (877) 866-7123

1301 Mesa Dr
Plainview, TX 79072-3905
Phone (877) 866-7123

1415 N 18TH St
Memphis, TX 79245-2009
Phone (877) 866-7123

1621 Butler Dr
Dimmitt, TX 79027-2701
Phone (877) 866-7123

3101 S Main St
Perryton, TX 79070-5345
Phone (806) 435-5403

7441 Paseo del Norte
El Paso, TX 79911-3158
Phone (915) 842-8700

950 Camino del Rey
Socorro, TX 79927-4288
Phone (877) 866-7123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP05954LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Sep 11, 2024 Accepting new patients
Vohra Post Acute Care Physicians of Texas, PLLC CurrentSince Sep 30, 2024 Accepting new patients

Locations

3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951

1201 Clarks Dr
Abilene, TX 79602
Phone (325) 670-9185

3830 Mustang Rd
Alvin, TX 77511
Phone (281) 585-8484

401 W Arbrook Blvd
Arlington, TX 76014
Phone (817) 466-3094

5800 W Baker Rd
Baytown, TX 77520
Phone (281) 424-4541

2660 Brickyard Rd
Beaumont, TX 77703
Phone (406) 892-1533

17218 Preston Rd
Ste 2000
Dallas, TX 75252
Phone (469) 518-8472

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

1500 Sunset Dr
Friendswood, TX 77546
Phone (281) 922-4300

Organizations & group practices 2

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": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1154646388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 395",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707220395",
            "telephone_number": "225-683-5292",
            "fax_number": "225-683-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11990 JACKSON ST",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707223210",
            "telephone_number": "225-683-5292",
            "fax_number": "225-683-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMACKER",
        "first_name": "SHANNON",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-31",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP05954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2143671",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, LA

Sources for this page

Verify at the official NPI Registry.