Individual provider Active NPI

Shannon S Livingston, MD

  • Family Medicine Physician
  • Boerne, TX
National Provider Identifier
1477547099
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M0330 Issued in TX
Practice address
138 State Highway 46 W
Boerne, TX 78006-8114
Phone
(830) 630-9020
Fax
(830) 626-9037
NPI assigned
Sep 9, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M0330 TX Primary

Addresses

Primary practice location

138 State Highway 46 W
Boerne, TX 78006-8114

Mailing address

138 State Highway 46 W
Boerne, TX 78006-8114
Phone (830) 630-9020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051017000735 TX Practitioner - Family Practice 1052383056 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M0330TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon S. Livingston, M.D., P.a. Family Medicine CurrentSince Sep 25, 2025 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1477547099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 STATE HIGHWAY 46 W",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780068114",
            "telephone_number": "830-630-9020",
            "fax_number": "830-626-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 STATE HIGHWAY 46 W",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780068114",
            "telephone_number": "830-630-9020",
            "fax_number": "830-626-9037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "SHANNON",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M0330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

Verify at the official NPI Registry.