Shannon Leigh Vinson, APRN
Individual provider Active NPI Nurse Practitioner · Covington, LA
NPI 1962818690 · NPPES record last updated Dec 4, 2019
Key facts
- NPI
- 1962818690
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APN-0994122-NP (CO)
- Practice address
- 1202 S Tyler St
Covington, LA 70433-2330 - Phone
- (985) 898-4000
- NPI assigned
- Jul 2, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141010002339 | LA | Practitioner - Nurse Practitioner | 1557581659 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN-0994122-NP | CO | MD | Nurse Practitioner |
| AP07689 | LA | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Portercare Adventist Health System | Current | Accepting new patients | |
| Portercare Adventist Health System | Current |
Accepting new patients | |
| St. Tammany Parish Hospital Service District No 1 | Current |
Accepting new patients | |
| St Tammany Parish Hospital Service District No 1 | Current |
Accepting new patients | |
| Portercare Adventist Health System | Current |
Accepting new patients |
Locations
7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650
2551 W 84th Ave
Westminster, CO 80031
Phone (303) 202-1280
1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APN-0994122-NP | CO | Yes |
| Adult Health Nurse Practitioner | 363LA2200X | AP07689 | LA |
Addresses
Primary practice location
1202 S Tyler St
Covington, LA 70433-2330
Mailing address
PO Box 54482
New Orleans, LA 70154-4482
Phone (985) 898-4451
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AP07689 | Other | LA | ADVANCED PRACTICE RN LICENSE |
Other providers in Covington, LA
- Kelly Villars
- Heath Villere
- Mashezia Janese Vincent
- Landin Vincifora
- Liam Edward Vincifora
- Laken Viola
- Vision Care Plus Inc.
- Vision Optique Inc
- Vision Optique Inc
- Vision Rehabilitation Specialists LLC
All providers in Covington, LA · Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.