Individual provider Active NPI

Shannon Wait, APRN, FNP-C

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1710547328
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11002971 Issued in FL
Practice address
1628 Lockhill Selma Rd
San Antonio, TX 78213-1929
Phone
(210) 265-5920
NPI assigned
Jun 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11002971 FL Primary

Addresses

Primary practice location

1628 Lockhill Selma Rd
San Antonio, TX 78213-1929

Mailing address

1628 Lockhill Selma Rd
San Antonio, TX 78213-1929
Phone (210) 265-5920

Other practice location 1

19026 Ridgewood Pkwy Ste 311
San Antonio, TX 78259-5502
Phone (833) 210-4673

Other practice location 2

1200 Brooklyn Ave Ste 320
San Antonio, TX 78212-4803
Phone (210) 229-7242

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
I20210120003131 TX Practitioner - Nurse Practitioner 0547698094 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Jul 22, 2022 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. Current Accepting new patients

Locations

1102 Barclay St
San Antonio, TX 78207
Phone (210) 434-0513

14625 Huebner Rd
San Antonio, TX 78230

1200 Brooklyn Ave
Ste 320
San Antonio, TX 78212
Phone (210) 225-5741

3066 E Commerce St
San Antonio, TX 78220
Phone (210) 233-7062

Interoperability endpoints

  • Direct secure messaging: shannon.wait@3555.securemail.prognocis.com

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": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1710547328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 LOCKHILL SELMA RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131929",
            "telephone_number": "210-265-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 LOCKHILL SELMA RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131929",
            "telephone_number": "210-265-5920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19026 Ridgewood Pkwy Ste 311",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782595502",
            "country_code": "US",
            "telephone_number": "833-210-4673",
            "fax_number": "833-211-4673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Brooklyn Ave Ste 320",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782124803",
            "country_code": "US",
            "telephone_number": "210-229-7242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAIT",
        "first_name": "SHANNON",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11002971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.