Shannon D Leake, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0002825-C-NP Issued in CO

Practice address

410 N Jefferson Ave # 262
Mount Pleasant, TX 75455-3937

Phone

(903) 287-5788

Fax

(903) 213-9031

NPI assigned

Dec 30, 2019

Last updated

Sep 23, 2021By 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 3

Addresses

Other identifiers 3

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Consave Health, PLLC

  • Nurse Practitioner
  • Texarkana, TX
  • NPI 1750157087
  NPD Authorized official

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1598304115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 COUNTY ROAD 1612",
            "address_2": "410 NORTH JEFFERSON AVENUE #262",
            "city": "MOUNT PLEASANT",
            "state": "TX",
            "postal_code": "754553937",
            "telephone_number": "903-287-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N JEFFERSON AVE # 262",
            "city": "MOUNT PLEASANT",
            "state": "TX",
            "postal_code": "754553937",
            "telephone_number": "903-287-5788",
            "fax_number": "903-213-9031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAKE",
        "first_name": "SHANNON",
        "middle_name": "D",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-30",
        "last_updated": "2021-09-23",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP144577",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "63678",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0002825-C-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO DEPARTMENT OF REGULATORY AGENCIES DIVISION OF PROFESSIONS AND OCCUPATIO",
            "identifier": "0002825-C-NP",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEXICO BOARD OF NURSING",
            "identifier": "63678",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BON",
            "identifier": "AP144577",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Kreusch, PTA
• Jennifer C Kriska, CPNP
• Amy Danielle Lawing, CRNA
• Allen Franklin Lawrence II, M.S., LPC
• Karma Lisa Lawrence, CFNP
• Kathleen Leeper, SLP
• Katy Leeves, PHARM.D.
• Madison Leeves
• Donna H. Leftwich, SLP
• Jessica S. Lewis, OTR

• Family Nurse Practitioner in Mount Pleasant, TX
• Providers in Mount Pleasant, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.