Individual provider Active NPI

Shannon B. Glass, MD

  • Diagnostic Radiology Physician
  • Tyler, TX
National Provider Identifier
1982923975
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
Q1611 Issued in TX
Practice address
11937 US Highway 271
Tyler, TX 75708
Phone
(903) 877-7777
NPI assigned
May 31, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X Q1611 TX Primary

Addresses

Primary practice location

11937 US Highway 271
Tyler, TX 75708

Mailing address

PO Box 846098
Dallas, TX 75284-1656
Phone (903) 531-5000

Other practice location 1

705 E Marshall Ave Ste 1003
Longview, TX 75601-5660
Phone (903) 315-3860

Other practice location 2

719 W Coke Rd Ste 3
Winnsboro, TX 75494-3060
Phone (903) 342-5227

Other practice location 3

115 Airport Rd
Sulphur Springs, TX 75482-2105
Phone (903) 885-7671

Other practice location 4

700 E Marshall Ave
Longview, TX 75601-5580
Phone (903) 315-2000

Other practice location 5

800 E Dawson St
Tyler, TX 75701-2036
Phone (903) 606-5000

Other practice location 6

910 E Houston St Ste 650
Tyler, TX 75702-8370
Phone (903) 606-5300

Other practice location 7

11937 US Highway 271
Tyler, TX 75708-3154
Phone (903) 877-7777

Other practice location 8

811 S Washington Ave
Marshall, TX 75670-5336
Phone (903) 315-2130

Other identifiers 8

IdentifierTypeStateIssuer
P02057868OtherTXMEDICARE RAIL ROAD
8JW906OtherTXBCBS
P02057870OtherTXMEDICARE RAIL ROAD
348611003MedicaidTX
348611004MedicaidTX
667447OtherTXMEDICARE
667934OtherTXMEDICARE
8JP975OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150901002625 TX Practitioner - Diagnostic Radiology 4385950682 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Tulane University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mother Frances Hospital Regional Health Care CenterGroup PAC ID 9234025636, 120 clinicians

Practice addresses (Care Compare)

800 E Dawson St
Tyler, TX 75701-2036

910 E Houston St
650 Christus Mother Frances Hospital
Tyler, TX 75702-8370
Phone (903) 531-5300

910 E Houston St
Christus Mother Frances Hospital
Tyler, TX 75702-8369
Phone (903) 531-5300

Hospital & facility affiliations

  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
  • Christus Mother Frances Hospital- Jacksonville Hospital, Jacksonville, TX, CCN 451319
  • Baylor Scott & White Texas Spine & Joint Hospital Hospital, Tyler, TX, CCN 450864

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mother Frances Hospital Regional Health Care Center CurrentSince Jul 1, 2018 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jul 1, 2018 Accepting new patients
Mother Frances Hospital-Winnsboro CurrentSince Aug 17, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jul 1, 2018 Accepting new patients
Mother Frances Hospital-Winnsboro CurrentSince Aug 17, 2023 Accepting new patients
Mother Frances Hospital Winnsboro Past Accepting new patients
Mother Frances Hospital Past Accepting new patients

Locations

3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

115 Airport Rd
Sulphur Springs, TX 75482
Phone (903) 439-4052

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

910 E Houston St
Ste 650
Tyler, TX 75702
Phone (903) 510-5300

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

719 W Coke Rd
Ste 3
Winnsboro, TX 75494
Phone (903) 342-3376

719 W Coke Rd
Ste 4
Winnsboro, TX 75494
Phone (903) 342-3760

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1275264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1982923975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752841656",
            "telephone_number": "903-531-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11937 US HIGHWAY 271",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75708",
            "telephone_number": "903-877-7777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 E Marshall Ave Ste 1003",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015660",
            "country_code": "US",
            "telephone_number": "903-315-3860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "719 W Coke Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Winnsboro",
            "state": "TX",
            "postal_code": "754943060",
            "country_code": "US",
            "telephone_number": "903-342-5227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Airport Rd",
            "address_purpose": "LOCATION",
            "city": "Sulphur Springs",
            "state": "TX",
            "postal_code": "754822105",
            "country_code": "US",
            "telephone_number": "903-885-7671",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 E Marshall Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015580",
            "country_code": "US",
            "telephone_number": "903-315-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 E Dawson St",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012036",
            "country_code": "US",
            "telephone_number": "903-606-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "910 E Houston St Ste 650",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757028370",
            "country_code": "US",
            "telephone_number": "903-606-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11937 US Highway 271",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757083154",
            "country_code": "US",
            "telephone_number": "903-877-7777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "811 S Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Marshall",
            "state": "TX",
            "postal_code": "756705336",
            "country_code": "US",
            "telephone_number": "903-315-2130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLASS",
        "first_name": "SHANNON",
        "middle_name": "B.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-31",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "Q1611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "P02057868",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8JW906",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "P02057870",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "348611003",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "348611004",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "667447",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "667934",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8JP975",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.