Tiffany Lynn Shanahan, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A005159 Issued in AR

Practice address

3101 SE 14TH St
Bentonville, AR 72712

Phone

(479) 986-6090

Fax

(479) 986-6250

NPI assigned

May 19, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Health Northwest Arkansas CommunitiesGroup PAC ID 0648177873, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Home Health Home health agency, Rogers, AR, CCN 047149
• Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tshanahan19949@directc.mercy.net

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.

• Mercy Health Northwest Arkansas Communities

  • Multi-Specialty Clinic/Center
  • Rogers, AR
  • NPI 1265490916
  Medicare reassignment Care Compare group NPD
• Mercy Northwest Arkansas Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Springdale, AR
  • NPI 1366922320
  Medicare reassignment NPD
• Mercy Health Northwest Arkansas Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Rogers, AR
  • NPI 1770087371
  NPD

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

• Mercy Hospital Rogers

  dba Mercy Hospital Northwest Arkansas

  • General Acute Care Hospital
  • Rogers, AR
  • NPI 1316902414
  Care Compare affiliation
• Mercy Hospital Rogers

  • Home Health Agency
  • Rogers, AR
  • NPI 1942265160
  Care Compare affiliation

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

{
    "created_epoch": "1495152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1750818894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 SE 14TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124900",
            "telephone_number": "479-986-6090",
            "fax_number": "479-986-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SE 14TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "72712",
            "telephone_number": "479-986-6090",
            "fax_number": "479-986-6250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 SW Regional Airport Blvd",
            "address_purpose": "LOCATION",
            "city": "Bentonville",
            "state": "AR",
            "postal_code": "727124589",
            "country_code": "US",
            "telephone_number": "479-319-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Mercy Way Ste 20",
            "address_purpose": "LOCATION",
            "city": "Bella Vista",
            "state": "AR",
            "postal_code": "727143000",
            "country_code": "US",
            "telephone_number": "479-802-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "TIFFANY",
        "middle_name": "LYNN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Sevier, LPC
• Jeanie Ray Shade, LCSW
• Karl David Shade
• Kathryn M Shaffer, LPC
• Shamsul Alam MD PA (The Kidney Clinic)
• Shanna M. Molina MD PLLC
• Shannon Candid Arkansas, P.a.
• John Lark Shasteen, LCSW
• Ayesha Shaukat, RPH
• Kerri Shaw, M.S., CCC-SLP

• Family Nurse Practitioner in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.