Individual provider Active NPI

Shannon A Gannon, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1225909559
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1073562 Issued in TX
Practice address
4004 82ND St Ste G
Lubbock, TX 79423-2065
Phone
(806) 792-1050
NPI assigned
Sep 17, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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 1073562 TX Primary

Addresses

Primary practice location

4004 82ND St Ste G
Lubbock, TX 79423-2065

Mailing address

5219 City Bank Pkwy Ste 35
Lubbock, TX 79407-3545
Phone (806) 761-0333

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
I20260211004295 TX Practitioner - Nurse Practitioner 7012496730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umc PhysiciansGroup PAC ID 9830003631, 107 clinicians

Practice addresses (Care Compare)

4004 82ND St
Suite G
Lubbock, TX 79423-2065
Phone (806) 792-1050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1073562TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Umc Physicians Family CurrentSince Feb 24, 2026 Accepting new patients

Locations

4004 82nd St
Ste G
Lubbock, TX 79423
Phone (806) 792-1050

808 Joliet Ave
Lubbock, TX 79415
Phone (806) 722-7400

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

5219 City Bank Pkwy
Ste 35
Lubbock, TX 79407
Phone (806) 761-0334

Organizations & group practices 1

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 5

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": "1758067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1225909559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5219 CITY BANK PKWY STE 35",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794073545",
            "telephone_number": "806-761-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 82ND ST STE G",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794232065",
            "telephone_number": "806-792-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "SHANNON",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-09-17",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1073562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.