Individual provider Active NPI

Shannon Higgins Faires, FNP

  • Family Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1316226616
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000015866 Issued in TN
Practice address
2515 Desales Ave
Suite 206
Chattanooga, TN 37404-1100
Phone
(423) 698-8101
Fax
(423) 698-3450
NPI assigned
Aug 4, 2011
Last updated
Apr 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN0000015866 TN Primary

Addresses

Primary practice location

2515 Desales Ave
Suite 206
Chattanooga, TN 37404-1100

Mailing address

4976 Alpha LN
Hixson, TN 37343-5470
Phone (423) 497-5355

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
I20110922000406 TN Practitioner - Nurse Practitioner 3577734516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Medical Group, PCGroup PAC ID 2668377391, 122 clinicians

Practice addresses (Care Compare)

2515 Desales Ave
Suite 206
Chattanooga, TN 37404-1100
Phone (423) 698-8101

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15866TNMDPhysical Therapist
APN0000015866TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Medical Group, PC Family CurrentSince Jan 1, 2015 Accepting new patients

Locations

1651 Gunbarrel Rd
Ste 102
Chattanooga, TN 37421
Phone (423) 308-0292

1651 Gunbarrel Rd
Ste 302
Chattanooga, TN 37421
Phone (423) 899-2904

2515 Desales Ave
Ste 206
Chattanooga, TN 37404
Phone (423) 629-6550

4976 Alpha Ln
Hixson, TN 37343
Phone (423) 308-0280

Organizations & group practices 1

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 4

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": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1316226616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4976 ALPHA LN",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435470",
            "telephone_number": "423-497-5355",
            "fax_number": "423-308-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 DESALES AVE",
            "address_2": "SUITE 206",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041100",
            "telephone_number": "423-698-8101",
            "fax_number": "423-698-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRES",
        "first_name": "SHANNON",
        "middle_name": "HIGGINS",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-04",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000015866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.