Individual provider Active NPI

Shannon Leigh Roberts, NP

  • Nurse Practitioner
  • Powell, TN
National Provider Identifier
1255374880
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN7578 Issued in TN
Practice address
7744 Conner Rd
Powell, TN 37849-3509
Phone
(865) 546-9751
Fax
(865) 362-6681
NPI assigned
Jun 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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 APN7578 TN Primary

Addresses

Primary practice location

7744 Conner Rd
Powell, TN 37849-3509

Mailing address

1225 E Weisgarber Rd
Suite 200
Knoxville, TN 37909-2604
Phone (865) 584-4747

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
I20060405000714 TN Practitioner - Nurse Practitioner 1759390552 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

101 Cherokee PL
Suite 107
Loudon, TN 37774-4162
Phone (865) 408-9344

7744 Conner Rd
Powell, TN 37849-3509
Phone (865) 546-9751

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN7578TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, PLLC CurrentSince Mar 1, 2017 Accepting new patients
Southeastern Emergency Services P C Nurse Practitioner CurrentSince Sep 15, 2005 Accepting new patients
Summit Medical Group, PLLC CurrentSince Mar 1, 2017 Accepting new patients
County of Rutherford Office of Budget Director Past Accepting new patients
Summit Medical Group,PLLC Past Accepting new patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients
Southeastern Emergency Services of Memphis, P.C. Nurse Practitioner Past Accepting new patients
Cane Ridge Emergency Physicians LLC Past Accepting new patients
Summit Medical Group, PLLC Past Accepting new patients
Summit Medical Group, PLLC PastSince Jan 1, 2023 Accepting new patients

Locations

11130 Kingston Pike
Ste 7
Knoxville, TN 37934
Phone (865) 675-1953

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

11130 Kingston Pike
Ste 78
Knoxville, TN 37934
Phone (865) 675-1953

1900 N Winston Rd
Ste 300
Knoxville, TN 37919
Phone (865) 271-6000

550 Fort Loudoun Med Center Dr
Lenoir City, TN 37772
Phone (865) 271-6000

7744 Conner Rd
Powell, TN 37849
Phone (865) 546-9751

200 Stonecrest Blvd
Smyrna, TN 37167
Phone (615) 768-2000

Interoperability endpoints

  • Direct secure messaging: shannon.roberts.1@20785.direct.athenahealth.com

Organizations & group practices 10

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 1

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1255374880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E WEISGARBER RD",
            "address_2": "SUITE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092604",
            "telephone_number": "865-584-4747",
            "fax_number": "865-584-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7744 CONNER RD",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "378493509",
            "telephone_number": "865-546-9751",
            "fax_number": "865-362-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SHANNON",
        "middle_name": "LEIGH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN7578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, TN

Sources for this page

Verify at the official NPI Registry.