JENNIFER SHANNON BURRELL (MD) – Pediatrics Physician, NPI 1093991796

JENNIFER SHANNON BURRELL (MD) is a healthcare provider. based in Snellville, Georgia. specializing in Pediatrics Physician. They hold the professional credentials MD. They hold a License No. 001332 (GA). The NPI Number for JENNIFER SHANNON BURRELL (MD) is 1093991796

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER SHANNON BURRELL (MD)
NPI
1093991796
Phone
(770) 972-0812
Address
1700 TREE LN
Enumeration Date
14 January 2008
Last Update Date
4 October 2011

Doctor Profile

Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6783124321
Graduation Year
2005 (21 years ago)
PAC ID
3678717576
Group Practice PAC ID
0840373619
Professional Enrollment ID
I20130916000332
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

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Provider Addresses for JENNIFER SHANNON BURRELL (MD)

  • 1700, Tree Lane, Snellville, Gwinnett County, Georgia, 30078, United States

    SUITE 110

    SNELLVILLE, GA 300786782

    Phone: (770) 972-0812

    Fax: (770) 972-0850

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $78.

Total Amount is formed as General ($78) + Research ($0) + Ownership ($0) = $78.

Last reported payment date: 2024-02-08 • Largest payer in this snapshot: Fisher & Paykel Healthcare Inc ($78).

Total Amount

$78

General + Research + Ownership

Payments

1

Total payment records

General Amount

$78

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-08

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-09-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20130916000332IEmergency MedicineGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30078)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0840373619View full group profile
NameSpecialtyState
Nurse PractitionerGA
Emergency MedicineGA
Emergency MedicineGA
Emergency Medicine, HospitalistFL
Emergency MedicineGA
Emergency MedicineGA
-GA
-GA
-NY
Emergency MedicineGA

Reviews

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Frequently asked questions

Is there an official ID for JENNIFER SHANNON BURRELL (MD) in U.S. healthcare records?
The official identifier for JENNIFER SHANNON BURRELL (MD) is NPI 1093991796.
Is JENNIFER SHANNON BURRELL (MD) still an active registrant?
JENNIFER SHANNON BURRELL (MD) carries an active NPI according to the public dataset.
What kind of doctor is JENNIFER SHANNON BURRELL (MD)?
JENNIFER SHANNON BURRELL (MD) is associated with Pediatrics Physician in the directory — Clinical services aligned with this taxonomy classification.
Is JENNIFER SHANNON BURRELL (MD) located near Snellville?
JENNIFER SHANNON BURRELL (MD) currently maps to Snellville, Georgia in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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