Shannon Hextrum, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

321977 Issued in LA

Practice address

1415 Tulane Ave FL 5
New Orleans, LA 70112-2600

Phone

(504) 988-5561

NPI assigned

Apr 8, 2014

Last updated

Apr 28, 2021By the provider in NPPES

Sex

Female

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 LA, IL2 enrollments

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 2

Specialty

Neurology

Education

Loyola University of Chicago, Stritch School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rush University Medical Center Hospital, Chicago, IL, CCN 140119

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Rush University Medical Group

  dba Rush University Internists

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542

  Neurology

  Medicare reassignment Care Compare group NPD
• Administrators of the Tulane Educational Fund

  dba Tulane University Medical Center NorthShore Clinics

  • Specialist
  • Covington, LA
  • NPI 1245434224
  Medicare reassignment NPD
• Administrators of the Tulane Educational Fund

  dba Tulane University Medical Group

  • Specialist
  • New Orleans, LA
  • NPI 1528014164
  Medicare reassignment NPD
• Administrators of the Tulane Educational Fund

  • Specialist
  • Hattiesburg, MS
  • NPI 1033395298
  NPD

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

• Rush University Medical Center

  • Children's Hospital
  • Chicago, IL
  • NPI 1801908728
  Care Compare affiliation
• Rush University Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1932213600
  Care Compare affiliation

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1942629837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVENUE",
            "address_2": "#8047",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701123006",
            "telephone_number": "504-988-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 TULANE AVE FL 5",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122600",
            "telephone_number": "504-988-5561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "710 N Lake Shore Dr Ste 1105",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60611",
            "country_code": "US",
            "telephone_number": "312-503-2849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEXTRUM",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-08",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "LA",
            "license": "321977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Armando Hevia, MD
• Jennifer K Hew, RDH
• Maurice Hew, R.PH.
• Dora Hewitt, NURSE
• Nicole Corrine Hewitt
• Lara E Heyliger, MPT
• Aaliyah Shonntelle Heyward, MMSC
• Yvonne Lashell Heyward
• Kortney Hickenbottom
• Kierra Hickerson

• Neurology Physician in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Neurology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.