Active NPI
Shannon Kay Justema
- Family Nurse Practitioner
- Richardson, TX
National Provider Identifier
1639860125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1113478
- Practice address
- 3421 Spectrum Blvd Ste 100
Ste 100
Richardson, TX 75082-9705 - Phone
- (972) 234-5698
- Fax
- (214) 255-0390
- NPI assigned
- May 16, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1113478 | TX | Primary |
Addresses
Primary practice location
3421 Spectrum Blvd Ste 100
Ste 100
Richardson, TX 75082-9705
Mailing address
3421 Spectrum Blvd Ste 100
Richardson, TX 75082-9705
Phone (972) 234-5698
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1113478 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chronic Pain Relief Center | Past | Accepting new patients | |
| Southwest Texas Two Medical Group, PLLC | Past | Accepting new patients |
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.
-
- Clinic/Center
- Dallas, TX
- NPI 1073237590
-
- Primary Care Clinic/Center
- Houston, TX
- NPI 1659950475
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765065600000",
"number": "1639860125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3421 SPECTRUM BLVD STE 100",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750829705",
"telephone_number": "972-234-5698",
"fax_number": "214-225-0390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3421 SPECTRUM BLVD STE 100",
"address_2": "STE 100",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750829705",
"telephone_number": "972-234-5698",
"fax_number": "214-255-0390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUSTEMA",
"first_name": "SHANNON",
"middle_name": "KAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-16",
"last_updated": "2025-12-07",
"certification_date": "2025-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "1113478",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richardson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.