Individual provider Active NPI

Shannon Kimberly Tee, DC

  • Chiropractor
  • Coppell, TX
National Provider Identifier
1194578773
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
14216 Issued in TX
Practice address
255 S Denton Tap Rd Ste 200
Coppell, TX 75019-5050
Phone
(972) 393-6262
NPI assigned
Apr 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 14216 TX Primary

Addresses

Primary practice location

255 S Denton Tap Rd Ste 200
Coppell, TX 75019-5050

Mailing address

255 S Denton Tap Rd Ste 200
Coppell, TX 75019-5050
Phone (972) 393-6262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260520000851 TX Practitioner - Chiropractic 9830668771 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1845 E Southlake Blvd
Suite 140
Southlake, TX 76092-6501

PO Box
Suite 550
Ingram, TX 78025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14216TXMDChiropractor

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1194578773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 S DENTON TAP RD STE 200",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750195050",
            "telephone_number": "972-393-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S DENTON TAP RD STE 200",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750195050",
            "telephone_number": "972-393-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEE",
        "first_name": "SHANNON",
        "middle_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "14216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coppell, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.