Individual provider Active NPI

Shannon Adkins Childs, ACNP

  • Acute Care Nurse Practitioner
  • Ennis, TX
National Provider Identifier
1689680761
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
248707 Issued in TX
Practice address
717 W Lampasas St
Ennis, TX 75119-4533
Phone
(972) 875-6700
Fax
(972) 875-6790
NPI assigned
Jul 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 248707 TX Primary

Addresses

Primary practice location

717 W Lampasas St
Ennis, TX 75119-4533

Mailing address

506 Virginia Ave
PO Box 10
Waxahachie, TX 75165-1752
Phone (972) 937-4992

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101104000290 TX Practitioner - Nurse Practitioner 5799979621 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ellis County Medical AssociatesGroup PAC ID 5991779597, 7 clinicians

Practice addresses (Care Compare)

802 W Lampasas St
Ennis, TX 75119-4536
Phone 9728754700320

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Total Point - Desoto LLC CurrentSince May 16, 2023 Accepting new patients
Century Integrated Partners, Inc CurrentSince Jan 1, 2016 Accepting new patients
Ellis County Medical Associates CurrentSince Jan 1, 2015 Accepting new patients
D. Blayne Laws, M.D., P.a. Past Accepting new patients

Locations

2312 W 7th Ave
Corsicana, TX 75110
Phone (903) 448-7611

1601 Elm St
Ste 4210
Dallas, TX 75201

3500 Gaston Ave
Dallas, TX 75246

1111 N Interstate 35 E
Desoto, TX 75115
Phone (469) 530-9220

802 W Lampasas St
Ennis, TX 75119
Phone (972) 875-4700

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

1517 E Rusk St
Jacksonville, TX 75766
Phone (903) 339-2370

4700 Alliance Blvd
#P
Plano, TX 75093
Phone (469) 814-2000

1405 W Jefferson St
Waxahachie, TX 75165
Phone (972) 875-9000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AGFCAA

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689680761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 VIRGINIA AVE",
            "address_2": "PO BOX 10",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751651752",
            "telephone_number": "972-937-4992",
            "fax_number": "972-875-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 W LAMPASAS ST",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751194533",
            "telephone_number": "972-875-6700",
            "fax_number": "972-875-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDS",
        "first_name": "SHANNON",
        "middle_name": "ADKINS",
        "name_prefix": "Ms.",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "248707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ennis, TX

Sources for this page

Verify at the official NPI Registry.