Individual provider Active NPI

Shannon Hill Shelley, C.N.M.

  • Advanced Practice Midwife
  • Knoxville, TN
National Provider Identifier
1619182078
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
11574 Issued in TN
Practice address
501 19TH Street
Suite 509
Knoxville, TN 37916-1853
Phone
(865) 524-3208
Fax
(865) 522-4322
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 11574 TN Primary

Addresses

Primary practice location

501 19TH Street
Suite 509
Knoxville, TN 37916-1853

Mailing address

501 19TH Street
Suite 509
Knoxville, TN 37916-1853
Phone (865) 524-3208

Other names 1

  • Ms. Shannon Hill Nirode Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110222001030 TN Practitioner - Certified Nurse Midwife (CNM) 6507047677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Sanders Obstetrical and Gynecological Group, PCGroup PAC ID 1254416506, 11 clinicians

Practice addresses (Care Compare)

501 19TH St
Suite 509
Knoxville, TN 37916-1874
Phone (865) 524-3208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
11574TNMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Sanders Obstetrical and Gynecological Group, P.C. CurrentSince Jan 4, 2011 Accepting new patients
Fort Sanders Obstetrical and Gynecological Group II LLC Past Accepting new patients

Locations

501 19th St
Ste 509
Knoxville, TN 37916
Phone (423) 524-1024

Organizations & group practices 2

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": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1619182078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 19TH STREET",
            "address_2": "SUITE 509",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161853",
            "telephone_number": "865-524-3208",
            "fax_number": "865-522-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 19TH STREET",
            "address_2": "SUITE 509",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161853",
            "telephone_number": "865-524-3208",
            "fax_number": "865-522-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLEY",
        "first_name": "SHANNON",
        "middle_name": "HILL",
        "name_prefix": "Mrs.",
        "credential": "C.N.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TN",
            "license": "11574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "NIRODE",
            "middle_name": "HILL",
            "prefix": "MS.",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.