Individual provider Active NPI

Amanda Dawn Shannon, MSN, APRN, FNP-C

  • Nurse Practitioner
  • Copperas Cove, TX
National Provider Identifier
1205394228
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP139460 Issued in TX
Practice address
239 W Business 190
Copperas Cove, TX 76522-2912
Phone
(254) 542-9000
Fax
(254) 542-9001
NPI assigned
Mar 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP139460 TX Primary

Addresses

Primary practice location

239 W Business 190
Copperas Cove, TX 76522-2912

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Other practice location 1

2300 S Clear Creek Rd Ste 101
Killeen, TX 76549-4985
Phone (254) 634-4325

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ashannon274711@direct.sw.org Direct

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
I20190927001910 TX Practitioner - Nurse Practitioner 5597095901 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

239 W Business
190 Baylor Scott and White Clinic Coppe
Copperas Cove, TX 76522-2912
Phone (254) 542-9000

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healogics Specialty Physicians of Texas, PLLC Nurse Practitioner CurrentSince Jul 5, 2021 Accepting new patients
Scott & White Clinic CurrentSince May 18, 2022 Accepting new patients
Scott & White Clinic CurrentSince May 18, 2022 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

1105 Central Expy N
Ste 2210
Allen, TX 75013
Phone (972) 747-4325

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

239 W Business 190
Copperas Cove, TX 76522
Phone (254) 542-9000

2300 Clear Creek Rd
Ste 101
Killeen, TX 76549
Phone (254) 526-2985

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1552003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1205394228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 W BUSINESS 190",
            "city": "COPPERAS COVE",
            "state": "TX",
            "postal_code": "765222912",
            "telephone_number": "254-542-9000",
            "fax_number": "254-542-9001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 S Clear Creek Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Killeen",
            "state": "TX",
            "postal_code": "765494985",
            "country_code": "US",
            "telephone_number": "254-634-4325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "AMANDA",
        "middle_name": "DAWN",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-08",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP139460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ashannon274711@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "239 W Business 190",
            "city": "Copperas Cove",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765222912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Copperas Cove, TX

Sources for this page

Verify at the official NPI Registry.