Individual provider Active NPI

Shauna Lee Comella, NP-ACNPC-AG

  • Acute Care Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1245971621
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
31657 Issued in TN
Practice address
1669 Shelby Oaks Dr N Ste 106
Memphis, TN 38134-7441
Phone
(901) 382-9292
NPI assigned
Apr 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 31657 TN
Acute Care Nurse Practitioner 363LA2100X 31657 TN Primary

Addresses

Primary practice location

1669 Shelby Oaks Dr N Ste 106
Memphis, TN 38134-7441

Mailing address

965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220523001577 TN Practitioner - Nurse Practitioner 8628455193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1669 N Shelby Oaks Dr
Suite 106
Memphis, TN 38134-7441
Phone (901) 382-9292

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Hospice of Tennessee, LLC CurrentSince Sep 10, 2023 Accepting new patients
Crossroads Hospice of Tennessee CurrentSince Sep 10, 2023 Accepting new patients

Locations

1669 Shelby Oaks Dr N
Ste 106
Memphis, TN 38134
Phone (901) 382-9292

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": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1245971621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 SHELBY OAKS DR N STE 106",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381347441",
            "telephone_number": "901-382-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMELLA",
        "first_name": "SHAUNA",
        "middle_name": "LEE",
        "credential": "NP-ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "31657",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "31657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.