Individual provider Active NPI

Shannon Lee Bone, D.C.

  • Chiropractor
  • Jackson, TN
National Provider Identifier
1790756559
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1772 Issued in TN
Practice address
2012 Greystone Park
Jackson, TN 38305-3575
Phone
(731) 664-6998
Fax
(731) 664-7161
NPI assigned
Jan 30, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1772 TN Primary

Addresses

Primary practice location

2012 Greystone Park
Jackson, TN 38305-3575

Mailing address

2012 Greystone Park
Jackson, TN 38305-3575
Phone (731) 664-6998

Other names 1

  • Dr. Shannon Lee Bone Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040308001380 TN Practitioner - Chiropractic 4183511363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back Pain Relief Clinic, IncGroup PAC ID 4486541653, 4 clinicians

Practice addresses (Care Compare)

149 N Star Dr
Jackson, TN 38305-5634
Phone (731) 664-6998

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
45 Urgent Care, P.C. PastSince Mar 6, 2014 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1790756559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 GREYSTONE PARK",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053575",
            "telephone_number": "731-664-6998",
            "fax_number": "731-664-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 GREYSTONE PARK",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053575",
            "telephone_number": "731-664-6998",
            "fax_number": "731-664-7161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONE",
        "first_name": "SHANNON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "1772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "BONE",
            "middle_name": "LEE",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.