Individual provider Active NPI

Shannon Lynn Roden Ternan, M.D.

  • Anesthesiology Physician
  • Dallas, TX
National Provider Identifier
1598969602
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
M4928 Issued in TX
Practice address
1935 Medical District Dr
Department of Anesthesiology
Dallas, TX 75235-7701
Phone
(214) 456-6393
Fax
(214) 456-7232
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X M4928 TX
Anesthesiology Physician 207L00000X M4928 TX Primary

Addresses

Primary practice location

1935 Medical District Dr
Department of Anesthesiology
Dallas, TX 75235-7701

Mailing address

1935 Medical District Dr
Department of Anesthesiology
Dallas, TX 75235-7701
Phone (214) 456-6393

Other identifiers 1

IdentifierTypeStateIssuer
1908634 01MedicaidTX

Other names 1

  • Shannon Lynn Roden Former name

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
I20071106000485 TX Practitioner - Anesthesiology 9537256680 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Physician Medical Services for Children Inc CurrentSince Jan 1, 2024 Accepting new patients
Dallas Physician Medical Services for Children Inc Anesthesiology Current Accepting new patients
Complex Care Medical Services Corporation Past Accepting new patients

Locations

1935 Medical District Dr
Unit A
Dallas, TX 75235

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

Organizations & group practices 3

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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1598969602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "address_2": "DEPARTMENT OF ANESTHESIOLOGY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-6393",
            "fax_number": "214-456-7232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "address_2": "DEPARTMENT OF ANESTHESIOLOGY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-6393",
            "fax_number": "214-456-7232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERNAN",
        "first_name": "SHANNON",
        "middle_name": "LYNN RODEN",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "TX",
            "license": "M4928",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "M4928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1908634 01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "RODEN",
            "middle_name": "LYNN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.