Shannon R Bodiford, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

21117 Issued in TN

Practice address

2018 Western Ave
Knoxville, TN 37921-5718

Phone

(865) 544-0406

Fax

(865) 544-0480

NPI assigned

Apr 14, 2017

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 TN

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

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Cherokee Health Systems

  • Federally Qualified Health Center (FQHC)
  • Talbott, TN
  • NPI 1134128820
  Medicare reassignment NPD
• Cherokee Health Systems

  • Federally Qualified Health Center (FQHC)
  • White Pine, TN
  • NPI 1699666404
  NPD

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1972037000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 SULPHUR SPRINGS RD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378135654",
            "telephone_number": "423-317-9344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 WESTERN AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379215718",
            "telephone_number": "865-544-0406",
            "fax_number": "865-544-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODIFORD",
        "first_name": "SHANNON",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-14",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• X-Zaviana Boddie
• Arianna Boddy, PSY.D.
• Ryan Boddy, PHD
• Marc A. Bodenheimer, M.D.
• Danielle Bodey
• Body Mind Realign Inc
• Aimee Boer
• Matthew Bogardus
• Cynthia Boger, OD
• Kelly Patrice Boggan, MD

• Family Nurse Practitioner in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.