Shannon E Phillips Jr., N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

669011 Issued in TX

Practice address

409 Cottage Rd
Carthage, TX 75633-1466

Phone

(903) 694-4824

NPI assigned

Feb 2, 2006

Last updated

Mar 28, 2023By the provider in NPPES

Sex

Male

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 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

Specialty

Nurse Practitioner

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Quitman Hospital LLCGroup PAC ID 9133484330, shared by 6 NPIs, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut Health East Texas Quitman Hospital Hospital, Quitman, TX, CCN 451380

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssmith838106@ahs.direct-ci.com

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.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment NPD
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD
• Dailey Medical Clinic

  • Family Medicine Physician
  • Canton, TX
  • NPI 1609818053
  NPD (past)
• Fred E Griffiths

  dba House Call Doctors Texas

  • Geriatric Medicine (Family Medicine) Physician
  • Austin, TX
  • NPI 1609821719
  NPD (past)
• Quitman Hospital LLC

  • Rural Health Clinic/Center
  • Canton, TX
  • NPI 1932608452
  NPD (past)
• San Angelo Emergency Physicians

  • Emergency Medicine Physician
  • San Angelo, TX
  • NPI 1134177975
  NPD (past)

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

• Quitman Hospital LLC

  • Critical Access Hospital
  • Quitman, TX
  • NPI 1477061885
  Care Compare affiliation

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1811969165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 76",
            "city": "CANTON",
            "state": "TX",
            "postal_code": "75103",
            "telephone_number": "903-962-3419",
            "fax_number": "903-385-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 COTTAGE RD",
            "city": "CARTHAGE",
            "state": "TX",
            "postal_code": "756331466",
            "telephone_number": "903-694-4824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SHANNON",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "669011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Panola 501 Partners, LP (Panola Nursing & Rehabilitation Center)
• Panola Charter School
• Panola Dental, PLLC
• Panola Emergency Medicine Associates PA
• Jim Jason Phillips, MD
• Premise Health of Texas Medical PA (LP-Carthage)
• Premise Health of Texas Medical, P.a (CareHere A Premise Health company eHealth Center- Carthage)
• Joyce Printers
• Laura Michelle Privett, LMT
• QV Urgent Care TX PLLC (QuickVisit Urgent Care)

• Family Nurse Practitioner in Carthage, TX
• Providers in Carthage, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.