Active NPI
Debra Shannon
- Surgery Physician
- Bartlett, TN
National Provider Identifier
1871192773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 197509
- Practice address
- 2986 Kate Bond Rd
Bartlett, TN 38133-4003 - Phone
- (901) 820-7460
- NPI assigned
- Oct 21, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 197509 | TN | Primary |
Addresses
Primary practice location
2986 Kate Bond Rd
Bartlett, TN 38133-4003
Mailing address
1425 Karcher Rd
Somerville, TN 38068-5754
Phone (901) 484-8553
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 197509 | TN | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603238400000",
"number": "1871192773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1425 KARCHER RD",
"city": "SOMERVILLE",
"state": "TN",
"postal_code": "380685754",
"telephone_number": "901-484-8553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2986 KATE BOND RD",
"city": "BARTLETT",
"state": "TN",
"postal_code": "381334003",
"telephone_number": "901-820-7460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANNON",
"first_name": "DEBRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-21",
"last_updated": "2020-10-21",
"certification_date": "2020-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TN",
"license": "197509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bartlett, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.