Individual provider Active NPI

Shannon Melissa Maggard, APRN

  • Family Nurse Practitioner
  • Pikeville, KY
National Provider Identifier
1326719154
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3016620 Issued in KY
Practice address
200 Nursing Home LN
Pikeville, KY 41501-6896
Phone
(731) 394-1145
NPI assigned
Sep 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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 3016620 KY Primary

Addresses

Primary practice location

200 Nursing Home LN
Pikeville, KY 41501-6896

Mailing address

36 Pemberton CV
Jackson, TN 38305-5514
Phone (731) 394-1145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20211013000922 KY Practitioner - Nurse Practitioner 0446658066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultra Health LLCGroup PAC ID 6800186602, 151 clinicians
Pineville Community Health Center IncGroup PAC ID 5698009157, shared by 4 NPIs, 39 clinicians

Practice addresses (Care Compare)

718 Goodwin LN
Leitchfield, KY 42754-1400
Phone (731) 394-1145

850 Riverview Ave
Pineville, KY 40977-1452
Phone 6063373051251

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Health LLC CurrentSince Sep 29, 2021 Accepting new patients

Locations

366 S Washington St
Clinton, KY 42031
Phone (270) 653-2461

390 Park Ave
Hazard, KY 41701
Phone (606) 439-2306

718 Goodwin Ln
Leitchfield, KY 42754
Phone (270) 259-3676

200 Nursing Home Ln
Pikeville, KY 41501
Phone (606) 509-7343

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1326719154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 PEMBERTON CV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383055514",
            "telephone_number": "731-394-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NURSING HOME LN",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415016896",
            "telephone_number": "731-394-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGGARD",
        "first_name": "SHANNON",
        "middle_name": "MELISSA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3016620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikeville, KY

Sources for this page

Verify at the official NPI Registry.