SHANNON L MCTIRE (NPI# 1942438411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942438411 |
| Entity Type | Individual |
| Full Name | SHANNON L MCTIRE |
| Credential | NP |
| Practice Address |
1500 Line Ave Suite 204 Shreveport LA 71101-4639 |
| Mailing Address |
1500 Line Ave Suite 202 Shreveport LA 71101-4639 |
| Practice Telephone | 3186295001 |
| Practice Fax Number | 3186295020 |
| Mailing Telephone | 3186295505 |
| Mailing Fax Number | 3186295506 |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2009-09-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | AP05879 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1500 LINE AVE SUITE 204 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101-4639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164427829 | Stephen L. Cox | Orthopaedic Surgery | 1500 Line Ave, Suite 100, Shreveport, LA 71101-4644 | 2005-06-17 |
| 1952944894 | Red River Medicine, LLC | Internal Medicine | 1500 Line Ave, Shreveport, LA 71101-4639 | 2019-10-23 |
| 1659871887 | Valerie Taylor Thompson | Physical Therapist | 1500 Line Ave, Shreveport, LA 71101-4639 | 2018-02-14 |
| 1356892665 | Ryan D Elledge | Physician Assistant | 1500 Line Ave, Suite 200, Shreveport, LA 71101-4639 | 2016-10-21 |
| 1487109138 | Kristen Jones Brezina | Physician Assistant | 1500 Line Ave, Suite 100, Shreveport, LA 71101-4639 | 2016-08-23 |
| 1619328838 | Meghan Marie Williams | Occupational Therapist | 1500 Line Ave, Suite 100, Shreveport, LA 71101-4639 | 2016-06-29 |
| 1285023010 | Mca Specialists Hospital, LLC | Anesthesiology | 1500 Line Ave, Shreveport, LA 71101-4639 | 2015-01-16 |
| 1093131765 | Kelly Daniels | Physical Therapist | 1500 Line Ave, Shreveport, LA 71101-4639 | 2014-03-05 |
| 1245678432 | Laura Elise Bares | Physical Therapist | 1500 Line Ave, Suite 104, Shreveport, LA 71101-4639 | 2013-06-10 |
| 1710233721 | Elvira Cehajic | Nurse Practitioner | 1500 Line Ave, Ste 100, Shreveport, LA 71101-4639 | 2012-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255988630 | Renee Jewitt | Case Manager/Care Coordinator | 1513 Line Avenue, Suite 225, Shreveport, LA 71101 | 2019-08-21 |
| 1942770094 | Bessie Larry | Case Manager/Care Coordinator | 1513 Line Av, 222, Shreveport, LA 71101 | 2018-12-03 |
| 1750875944 | Jarvis Decarleonne Larry | Community Health Worker | 1513 Line Ave # 222, Shreveport, LA 71101 | 2018-06-20 |
| 1871083485 | Kimberly B. Mcclelland, Lcsw | Counselor | 820 Jordan St. Ste 510w, Shreveport, LA 71101 | 2018-05-18 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1528572955 | Spencer Ron Floyd | Counselor | 1717 Marshall Street, Shreveport, LA 71101 | 2017-11-21 |
| 1578088076 | Brittany Morris | Case Manager/Care Coordinator | 1835 Spring Street Annex Building, Shreveport, LA 71101 | 2017-08-07 |
| 1275058794 | Diane Williams | Case Manager/Care Coordinator | 217 Jones St Apt 510, Shreveport, LA 71101 | 2017-08-04 |
| 1386195972 | Jakeya Woodbury | Counselor | 453 Stoner Ave, Shreveport, LA 71101 | 2016-10-18 |
| 1922459643 | Arlene Huling | Counselor | 449 Egan Street, Shreveport, LA 71101 | 2016-06-23 |
| Find all providers in zip 71101 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518508282 | Whitney Jackson | Nurse Practitioner | 1549 E 70th St Ste 300, Shreveport, LA 71105-5056 | 2019-10-03 |
| 1407322209 | Tiffany Michelle Williams | Nurse Practitioner | 7551 Youree Dr, Shreveport, LA 71105-5533 | 2018-10-18 |
| 1801334453 | Katoya Johnson | Nurse Practitioner | 1005 Quail Creek Rd Apt A, Shreveport, LA 71105-2310 | 2017-02-03 |
| 1023565298 | Primary Care At Home of Louisiana, LLC | Nurse Practitioner | 6425 Youree Dr Ste 290, One Bellemead Center, Shreveport, LA 71105-4634 | 2016-09-06 |
| 1457546095 | Julia B Henry | Nurse Practitioner | 2751 Albert L Bicknell Dr Ste 2d, Shreveport, LA 71103-3939 | 2007-09-06 |
| 1588867485 | Donna Rogers Hewitt | Nurse Practitioner | 1800 E 70th St, Shreveport, LA 71105-5338 | 2007-06-07 |
| 1134215361 | Angela Birdsong Fellows | Nurse Practitioner | 1666 E Bert Koun Loop, Shreveport, LA 71105-5714 | 2006-10-05 |
| 1942220959 | Tammy Rene Bennett | Nurse Practitioner | 1525 Fairfield Ave Ste 569, Office of Public Health, Shreveport, LA 71101-4331 | 2006-07-20 |
| 1134149859 | John Charles Charity | Nurse Practitioner | 503 Broadmoor Blvd, Shreveport, LA 71105-2023 | 2006-07-19 |
| 1144829540 | Jenna Nicole Blundell | Nurse Practitioner | 1811 E Bert Kouns Industrial Loop Ste 210, Shreveport, LA 71105-5740 | 2020-10-19 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.