Individual provider Active NPI

Janna Beth Shaull, R.N.

  • Community Health Registered Nurse
  • Jackson, TN
National Provider Identifier
1750402434
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
RN0000120991 Issued in TN
Practice address
295 Summar Dr
Jackson, TN 38301-3905
Phone
(731) 421-6767
Fax
(731) 421-5148
NPI assigned
Apr 2, 2007
Last updated
May 18, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN0000120991 TN Primary

Addresses

Primary practice location

295 Summar Dr
Jackson, TN 38301-3905

Mailing address

6600 Highway 412 W
Lexington, TN 38351-5405
Phone (731) 968-8038

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN0000120991TNMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1750402434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 HIGHWAY 412 W",
            "city": "LEXINGTON",
            "state": "TN",
            "postal_code": "383515405",
            "telephone_number": "731-968-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013905",
            "telephone_number": "731-421-6767",
            "fax_number": "731-421-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAULL",
        "first_name": "JANNA",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "TN",
            "license": "RN0000120991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.