Shannon Jackson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

124643 Issued in TN

Practice address

1901 Clinch Ave
Knoxville, TN 37916-2307

Phone

(865) 541-1111

NPI assigned

Jan 3, 2019

Sex

Female

Sole proprietor

Yes

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

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant Anesthesia Group PCGroup PAC ID 6901795830, 231 clinicians

American Anesthesiology of Tennessee PCGroup PAC ID 9931001922, 296 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fort Sanders Regional Medical Center Hospital, Knoxville, TN, CCN 440125

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• American Anesthesiology of Tennessee, P.C.

  • Anesthesiology Physician
  • Knoxville, TN
  • NPI 1609822998
  Medicare reassignment Care Compare group NPD
• Covenant Anesthesia Group, PC

  • Anesthesiology Physician
  • Oak Ridge, TN
  • NPI 1639148117
  Medicare reassignment Care Compare group NPD
• Pediatrix Medical Group of Tennessee, P.C.

  • Neonatal-Perinatal Medicine Physician
  • Nashville, TN
  • NPI 1497852107
  NPD (past)

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

• Fort Sanders Regional Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1942294814
  Care Compare affiliation

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1972076875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MOUNTAIN PASS LN",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379235723",
            "telephone_number": "615-351-7608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 CLINCH AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162307",
            "telephone_number": "865-541-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHANNON",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-03",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "124643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renita Jackson
• Robert C Jackson, MD
• Roshana Jackson
• Sara Izora Jackson
• Shajai Jackson
• Taylor Jackson, BA
• Thomas E Jackson, ANP
• Tonka Ruth McKenzie Jackson, MS
• Whitney Jackson
• Carrie Bridwell Jacobs, LCSW

• Certified Registered Nurse Anesthetist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

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