Individual provider Active NPI

Shannon Burke, D.O.

  • Pulmonary Disease Physician
  • Jackson, TN
National Provider Identifier
1245686401
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
4804 Issued in TN
Practice address
587 Skyline Dr
Jackson, TN 38301-3938
Phone
(731) 422-7900
Fax
(731) 599-4246
NPI assigned
May 6, 2016
Last updated
Aug 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 4804 TN
Pulmonary Disease Physician 207RP1001X 4804 TN Primary

Addresses

Primary practice location

587 Skyline Dr
Jackson, TN 38301-3938

Mailing address

257 Bancorp South Pkwy
Jackson, TN 38305-7582
Phone (731) 660-7971

Other practice location 1

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 257-8000

Other practice location 2

SLUCare Center for Specialized Medicine
1225 South Grand Boulevard
Saint Louis, MO 63104
Phone (314) 977-6109

Other names 1

  • Shannon Price Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220616001903 TN Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 5597053702 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Kansas City University of Physicians and Surgeons, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians

Practice addresses (Care Compare)

587 Skyline Dr
Jackson, TN 38301-3938
Phone (731) 422-7900

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.74 of 100Reported as apm
Quality
85.23
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4804TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Medical Group Inc Multi-Specialty Current Accepting new patients
West Tennessee Healthcare Hospitalists Inc Multi-Specialty CurrentSince Jun 1, 2022 Accepting new patients
Jackson Surgical Associates. PA Multi-Specialty Past Accepting new patients

Locations

257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283

587 Skyline Dr
Jackson, TN 38301
Phone (731) 421-6510

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

Interoperability endpoints

  • Direct secure messaging: sburke26643@directepic.wth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1245686401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 BANCORP SOUTH PKWY",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383057582",
            "telephone_number": "731-660-7971",
            "fax_number": "731-660-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013938",
            "telephone_number": "731-422-7900",
            "fax_number": "731-599-4246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041016",
            "country_code": "US",
            "telephone_number": "314-257-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "SLUCare Center for Specialized Medicine",
            "address_2": "1225 South Grand Boulevard",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "63104",
            "country_code": "US",
            "telephone_number": "314-977-6109",
            "fax_number": "314-977-6164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURKE",
        "first_name": "SHANNON",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-06",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TN",
            "license": "4804",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TN",
            "license": "4804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "PRICE",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.