Konica Shannon McMullen, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-093551 Issued in AL

Practice address

1769 Moss Rose Dr
Bessemer, AL 35022-8340

Phone

(205) 310-2600

Fax

(205) 236-1724

NPI assigned

Aug 8, 2022

Last updated

Nov 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CHBIDD

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.

• Birmingham Internal Medicine Associates, LLC

  • Internal Medicine Physician
  • Birmingham, AL
  • NPI 1598796542

  Family

  Medicare reassignment NPD
• Summit Physician Group LLP

  • Family Medicine Physician
  • Tuscaloosa, AL
  • NPI 1104343581
  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AL

  Medicare reassignment NPD
• Comprehensive Pediatrics and Internal Medicine, LLC

  • Internal Medicine Physician
  • Hoover, AL
  • NPI 1992339246
  NPD (past)

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1184352296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1769 MOSS ROSE DR",
            "city": "BESSEMER",
            "state": "AL",
            "postal_code": "350228340",
            "telephone_number": "205-310-2600",
            "fax_number": "205-236-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1769 MOSS ROSE DR",
            "city": "BESSEMER",
            "state": "AL",
            "postal_code": "350228340",
            "telephone_number": "205-310-2600",
            "fax_number": "205-236-1724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "KONICA",
        "middle_name": "SHANNON",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-093551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "299342",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-AL",
            "identifier": "512-90226",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne McDaniel
• Caitlin McDonald, PHARMD
• Richard Timothy McGlaughlin, M.D.
• Dahlia H McKinney, M.D.
• Jerry Thomas McLane, MD
• Alicia R McNeill, RD
• Med-West Anesthesia PC
• Medical Transport of Alabama
• Medical West Hospital Authority, an Affiliate of Uab Health System (Medical Center Pharmacy)
• Medical West Hospital Authority, an Affiliate of Uab Health System (UAB Medical West)

• Family Nurse Practitioner in Bessemer, AL
• Providers in Bessemer, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.

Verify at the official NPI Registry.