Shannon Wade Myers, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2000 Issued in TN

Practice address

111 Broyles St
Suite 6
Johnson City, TN 37601-2532

Phone

(423) 610-0005

Fax

(423) 610-0009

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN

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.

• Shannon Myers DC LLC

  • Chiropractor
  • Johnson City, TN
  • NPI 1407012495
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1982622601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 CHEROKEE RD",
            "address_2": "12",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BROYLES ST",
            "address_2": "SUITE 6",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012532",
            "telephone_number": "423-610-0005",
            "fax_number": "423-610-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "SHANNON",
        "middle_name": "WADE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4091317",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1407012495",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1982622601",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alice Myers, APN
• James Lee Myers, PA-C
• James W Myers, M.D.
• Jason B Myers, BM
• Logan Myers, LPC- MHSP
• Shouji Nagata
• Sagar Nagpal, MBBS
• Hemang Naik, MD
• Gabrielle Naillon
• Neha Naithani, MBBS

• Chiropractor in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.