Individual provider Active NPI

Shanna L. Wilkes, APN

  • Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1306878202
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
12114 Issued in TN
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

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061208000253 TN Practitioner - Nurse Practitioner 3476552076 Reassigns benefits to 4 organizations

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
Curana Health of Tennessee LLCGroup PAC ID 7416261482, 56 clinicians
Truhealth LLCGroup PAC ID 2163653478, 43 clinicians

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 Hospital, Jackson, TN, CCN 440002

Merit-based Incentive Payment System (MIPS)

Final score
89.78 of 100Reported as group
Quality
79.9
Improvement activities
40
Cost
80.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12114TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Truhealth, LLC Nurse Practitioner CurrentSince Nov 20, 2023 Accepting new patients
Delta Clinics, PLC CurrentSince Feb 17, 2016 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

  • Direct secure messaging: 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.

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": "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

Verify at the official NPI Registry.