Individual provider Active NPI

Shannon Horton Robertson, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1205265295
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
234773 Issued in LA
Practice address
12090 S Harrells Ferry Rd Ste G
Baton Rouge, LA 70816-2470
Phone
(985) 333-2020
NPI assigned
Nov 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 234773 LA Primary

Addresses

Primary practice location

12090 S Harrells Ferry Rd Ste G
Baton Rouge, LA 70816-2470

Mailing address

12327 Haven Ave
Baton Rouge, LA 70818-5736
Phone (225) 773-1330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20250116003292 LA Practitioner - Nurse Practitioner 6406384551 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
234773LAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Start Corporation CurrentSince Dec 1, 2024 Accepting new patients
Start Corporation CurrentSince Dec 1, 2024 Accepting new patients
Mosaic Minds CurrentSince Jul 9, 2025 Accepting new patients

Locations

12090 S Harrells Ferry Rd
Ste G
Baton Rouge, LA 70816
Phone (225) 773-1330

420 Magnolia St
Houma, LA 70360
Phone (985) 873-7784

235 Civic Center Blvd
Houma, LA 70360
Phone (985) 333-2020

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1205265295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12327 HAVEN AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708185736",
            "telephone_number": "225-773-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12090 S HARRELLS FERRY RD STE G",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708162470",
            "telephone_number": "985-333-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "SHANNON",
        "middle_name": "HORTON",
        "name_prefix": "Mrs.",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-11",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "234773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.