Individual provider Active NPI

Caleb Shannon, APRN, FNP-C

  • Family Nurse Practitioner
  • Abilene, TX
National Provider Identifier
1871210781
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1097169 Issued in TX
Practice address
5302 Buffalo Gap Rd
Abilene, TX 79606-4246
Phone
(325) 307-6226
NPI assigned
Oct 21, 2022
Last updated
Oct 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1097169 TX Primary

Addresses

Primary practice location

5302 Buffalo Gap Rd
Abilene, TX 79606-4246

Mailing address

1900 Pine St
Abilene, TX 79601-2432
Phone (325) 307-6226

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221115003256 TX Practitioner - Nurse Practitioner 5890163281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The West Texas Rehabilitation CenterGroup PAC ID 2860301215, shared by 5 NPIs, 444 clinicians
Hendrick Provider NetworkGroup PAC ID 9739162181, 234 clinicians

Practice addresses (Care Compare)

4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3411

5302 Buffalo Gap Rd
Suite 104
Abilene, TX 79606-4251
Phone (325) 307-6226

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.51 of 100Reported as group
Quality
63.02
Promoting interoperability
100
Improvement activities
40
Cost
65.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1097169TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hendrick Provider Network CurrentSince Jan 1, 2023 Accepting new patients
Hendrick Provider Network CurrentSince Jan 1, 2023 Accepting new patients

Locations

1900 Pine St
Abilene, TX 79601
Phone (325) 670-4220

1904 Pine St
Ste 4A
Abilene, TX 79601
Phone (325) 437-4020

5302 Buffalo Gap Rd
Abilene, TX 79606
Phone (325) 307-6226

5302 Buffalo Gap Rd
Ste 104
Abilene, TX 79606
Phone (325) 307-6226

Interoperability endpoints

  • Direct secure messaging: caleb.shannon.1@21794.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1871210781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 PINE ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012432",
            "telephone_number": "325-307-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5302 BUFFALO GAP RD",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796064246",
            "telephone_number": "325-307-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "CALEB",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-10-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1097169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.