Shannon Rebecca Watkins, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

75356 Issued in TN

Practice address

233 Watkins LN
Jacksboro, TN 37757-3826

Phone

(423) 494-8819

NPI assigned

Jun 17, 2015

Last updated

Jun 17, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1396126181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 WATKINS LN",
            "city": "JACKSBORO",
            "state": "TN",
            "postal_code": "377573826",
            "telephone_number": "423-494-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 WATKINS LN",
            "city": "JACKSBORO",
            "state": "TN",
            "postal_code": "377573826",
            "telephone_number": "423-494-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "SHANNON",
        "middle_name": "REBECCA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "75356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF TN NURSING BOARD",
            "identifier": "75356",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Norma B Tidwell, NA
• Timothy M Hall DMD PC
• Valley Medical
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1466)
• Wal-Mart Stores East, LP (Vision Center 30-1466)
• Brent Webb, D.O.
• Wells Drugs Inc (Riggs Drug Jacksboro)
• Wells Drugs Inc (Riggs Drug Jacksboro)
• West Wellness PLLC
• Justin Lee Wilson, DPH

• Licensed Practical Nurse in Jacksboro, TN
• Providers in Jacksboro, TN by specialty
• Licensed Practical Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.