Shannon B Payseur, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M0858 Issued in TX

Practice address

17051 Dallas Pkwy Ste 250
Addison, TX 75001-7121

Phone

(972) 685-7330

Fax

(469) 666-1084

NPI assigned

Nov 17, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Preventive Medicine

Education

Meharry Medical College School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Hospital for Surgery Hospital, Addison, TX, CCN 670073

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• DFW Wound Management PLLC

  • Family Medicine Physician
  • Addison, TX
  • NPI 1952538076
  Medicare reassignment Authorized official
• DFW Wound Care

  • Family Medicine Physician
  • Addison, TX
  • NPI 1215333067
  NPD (past) Authorized official

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

• Metdalspi, LLC

  dba Methodist Hospital for Surgery

  • General Acute Care Hospital
  • Addison, TX
  • NPI 1023338142
  Care Compare affiliation

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654992000000",
    "number": "1891869517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 W LOVERS LN # 116-312",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752094330",
            "telephone_number": "469-277-2701",
            "fax_number": "469-666-1084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17051 DALLAS PKWY STE 250",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750017121",
            "telephone_number": "972-685-7330",
            "fax_number": "469-666-1084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYSEUR",
        "first_name": "SHANNON",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2022-06-12",
        "certification_date": "2022-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "TX",
            "license": "M0858",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M0858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER #",
            "identifier": "12529264",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218958101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas J Parks, MD
• Chelsei Lauren Parton, OTR/L
• Beena Patel, PHARM.D
• Ravi B Patel, M.D.
• Dwight D Patrick, LPC
• Eugene Pearson
• Pegasus Medical Transportation LLC
• Alexis Danshelle Pegues, PA-C
• Adam J Pehr, P.T.
• Lisa Pelo, ATP, OTR

• Family Medicine Physician in Addison, TX
• Providers in Addison, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.