Individual provider Active NPI

Donna Arlene Shannon, M.D.

  • Family Medicine Physician
  • Cedar Hill, TX
National Provider Identifier
1720052699
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L1743 Issued in TX
Practice address
345 N Highway 67
Cedar Hill, TX 75104-2134
Phone
(972) 956-5300
Fax
(972) 956-5393
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L1743 TX Primary

Addresses

Primary practice location

345 N Highway 67
Cedar Hill, TX 75104-2134

Mailing address

PO Box 9101
Coppell, TX 75019-9494
Phone (972) 745-7500

Other identifiers 4

IdentifierTypeStateIssuer
164476702MedicaidTX
8K2772OtherTXBC/BS
164476701OtherTXMEDICAID FOR DALLAS COUNTY
8B5494OtherTXMEDICARE FOR DALLAS COUNTY

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
I20040514001125 TX Practitioner - Family Practice 8426048083 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

5653 McPherson Blvd
Fort Worth, TX 76123-6023
Phone (682) 354-3100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L1743TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth CurrentSince Jun 1, 2008 Accepting new patients
Medhealth Family Medicine CurrentSince Jun 1, 2008 Accepting new patients
Primary Health Physicians, PLLC CurrentSince Aug 25, 2024 Accepting new patients
Advanced Pain & Rehabilitation Association PLLC Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

345 N Highway 67
Cedar Hill, TX 75104
Phone (972) 956-5300

2310 W University Dr
#1500
Denton, TX 76201
Phone (940) 220-5901

5653 McPherson Blvd
Fort Worth, TX 76123
Phone (682) 354-3100

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

104 S Main St
Keller, TX 76248
Phone (214) 295-9385

377 W Campbell Rd
Ste 100
Richardson, TX 75080
Phone (469) 232-2945

613 S Highway 78
Wylie, TX 75098
Phone (972) 941-8700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1720052699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9101",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750199494",
            "telephone_number": "972-745-7500",
            "fax_number": "972-471-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 N HIGHWAY 67",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751042134",
            "telephone_number": "972-956-5300",
            "fax_number": "972-956-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "DONNA",
        "middle_name": "ARLENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L1743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164476702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "8K2772",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID FOR DALLAS COUNTY",
            "identifier": "164476701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FOR DALLAS COUNTY",
            "identifier": "8B5494",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Hill, TX

Sources for this page

Verify at the official NPI Registry.