Individual provider Active NPI

Sherrie Bouissey, ANP

  • Nurse Practitioner
  • San Angelo, TX
National Provider Identifier
1295797991
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP110774 Issued in TX
Practice address
2142 Sunset Dr
San Angelo, TX 76904-6829
Phone
(325) 245-4000
NPI assigned
Apr 6, 2006
Last updated
Sep 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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 AP110774 TX Primary

Addresses

Primary practice location

2142 Sunset Dr
San Angelo, TX 76904-6829

Mailing address

2142 Sunset Dr
San Angelo, TX 76904-6829
Phone (325) 245-4000

Other identifiers 1

IdentifierTypeStateIssuer
140701706MedicaidTX

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
I20040218001076 TX Practitioner - Nurse Practitioner 5294620134 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians

Practice addresses (Care Compare)

120 E Beauregard Ave
San Angelo, TX 76903-5919
Phone (325) 747-1511

120 E Harris Ave
San Angelo, TX 76903-5904
Phone (325) 747-6741

2142 Sunset Dr
San Angelo, TX 76904-6829
Phone (325) 747-1511

2626 N Bryant Blvd
San Angelo, TX 76903-2861
Phone (325) 747-1511

3502 Knickerbocker Rd
San Angelo, TX 76904-7671
Phone (325) 747-2222

4251 Sunset Dr
San Angelo, TX 76904-5653
Phone (325) 747-2226

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP110774TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc Nurse Practitioner CurrentSince Jul 1, 2004 Accepting new patients
Regional Employee Assistance Program Inc Current Accepting new patients
Regional Employee Assistance Program Inc CurrentSince Jul 1, 2004 Accepting new patients
Shannon Clinic CurrentSince Oct 4, 2020 Accepting new patients
Regional Employee Assistance Program Inc Past Accepting new patients

Locations

2804 Lake Rd
Ste 5
Huntsville, TX 77340
Phone (979) 696-2422

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

2142 Sunset Dr
San Angelo, TX 76904
Phone (325) 245-4211

3501 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 947-6361

3535 Knickerbocker Rd
San Angelo, TX 76904
Phone (915) 947-6495

3555 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 224-5411

3605 Executive Dr
San Angelo, TX 76904
Phone (325) 949-9555

902 N Main St
San Angelo, TX 76903
Phone (325) 655-7391

Interoperability endpoints

  • Direct secure messaging: sbouissey38687@shannonhealth.direct-ci.com

Organizations & group practices 5

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 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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1295797991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 SUNSET DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046829",
            "telephone_number": "325-245-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 SUNSET DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046829",
            "telephone_number": "325-245-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUISSEY",
        "first_name": "SHERRIE",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP110774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140701706",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.