Shannon Sullivan-Evans, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN21230 Issued in TN

Practice address

423 Medical Park Dr Ste 100
Lenoir City, TN 37772-5641

Phone

(865) 271-6600

Fax

(865) 374-2102

NPI assigned

May 21, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Shannon Colleen Sullivan Former name

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fort Loudoun Medical Center Hospital, Lenoir City, TN, CCN 440110

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sullivan-evans.shannon@covenanthealth.cernerdirect.com

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.

• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010
  Medicare reassignment Care Compare group NPD
• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1871269415
  NPD
• Allied Medical Clinic, Inc.

  • General Practice Physician
  • Louisville, TN
  • NPI 1851595417
  NPD (past)
• Cherokee Health Systems

  • Federally Qualified Health Center (FQHC)
  • Talbott, TN
  • NPI 1134128820
  NPD (past)
• The Cornerstone of Recovery, Inc.

  • Substance Abuse Rehabilitation Facility
  • Louisville, TN
  • NPI 1558479758
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fort Loudoun Medical Center

  • General Acute Care Hospital
  • Lenoir City, TN
  • NPI 1609860659
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1336596121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 MEDICAL PARK DR STE 100",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377725641",
            "telephone_number": "865-271-6600",
            "fax_number": "865-374-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 MEDICAL PARK DR STE 100",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377725641",
            "telephone_number": "865-271-6600",
            "fax_number": "865-374-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN-EVANS",
        "first_name": "SHANNON",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-21",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN96411",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN21230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q022325",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sullivan-evans.shannon@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "423 Medical Park Dr Ste 100",
            "city": "Lenoir City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377725641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "SULLIVAN",
            "middle_name": "COLLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard E Stanley, M.D.
• Kelly Alexis Steely, CNP
• Gregory Todd Stevens
• Ann Stewart, OTR
• Troy W. Stovall, D.O.
• Robert Sherwood Sullivan, MD
• Bethany Summerall
• Summit Medical Group, PLLC
• Summit Medical Group, PLLC
• Summit Medical Group,PLLC

• Family Nurse Practitioner in Lenoir City, TN
• Providers in Lenoir City, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.

Verify at the official NPI Registry.