Active NPI
Shanna L. Wilkes, APN
- Nurse Practitioner
- Jackson, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 12114
- Practice address
- 17 Centre Plaza Drive
Jackson, TN 38305 - Phone
- (731) 512-0104
- Fax
- (731) 668-7388
- NPI assigned
- Jul 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 12114 | TN | |
| Nurse Practitioner | 363L00000X | 12114 | TN | Primary |
Addresses
Primary practice location
17 Centre Plaza Drive
Jackson, TN 38305
Mailing address
17 Centre Plaza Dr
Jackson, TN 38305-2862
Phone (731) 512-0104
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5865 Ridgeway Ctr Pkwy
Memphis, TN 38120-4032
Phone (337) 991-9276
597 W Forest Ave
Jackson, TN 38301-3935
Phone (731) 300-4800
Hospital & facility affiliations
- Jackson-Madison County General Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.78 of 100
- Quality
- 79.9
- Improvement activities
- 40
- Cost
- 80.29
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12114 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Truhealth, LLC | Nurse Practitioner | Current | Accepting new patients |
| Delta Clinics, PLC | Current | Accepting new patients |
Locations
597 W Forest Ave
Jackson, TN 38301
Phone (731) 300-4800
17 Centre Plaza Dr
Jackson, TN 38305
Phone (731) 512-0104
9486 Highway 412 W
Lexington, TN 38351
Phone (731) 512-0104
1971 Tennessee Ave N
Parsons, TN 38363
Phone (731) 614-1424
1645 Florence Rd
Savannah, TN 38372
Phone (731) 926-4200
Interoperability endpoints
- shannawilkes@hvcwtn.allscriptsdirect.net
Organizations & group practices 4
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.
-
- Nurse Practitioner
- Parsons, TN
- NPI 1063843951
-
- Family Nurse Practitioner
- Memphis, TN
- NPI 1750761060
-
- Cardiovascular Disease Physician
- Lexington, TN
- NPI 1396033379
-
- Internal Medicine Physician
- Memphis, TN
- NPI 1003575838
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jackson, TN
- NPI 1093705428
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697068800000",
"number": "1306878202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 CENTRE PLAZA DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383052862",
"telephone_number": "731-512-0104",
"fax_number": "731-668-7388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 CENTRE PLAZA DRIVE",
"city": "JACKSON",
"state": "TN",
"postal_code": "38305",
"telephone_number": "731-512-0104",
"fax_number": "731-668-7388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKES",
"first_name": "SHANNA",
"middle_name": "L.",
"name_prefix": "Ms.",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-07",
"last_updated": "2023-10-12",
"certification_date": "2023-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "TN",
"license": "12114",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TN",
"license": "12114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.