MR. SHANNON E JR. PHILLIPS (N.P.) – Family Nurse Practitioner, NPI 1811969165
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
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Provider Addresses for MR. SHANNON E JR. PHILLIPS (N.P.)
76, Post Road, Crary Mills, Canton, Saint Lawrence County, New York, 13617, United States
CANTON, TX 75103
Phone: (903) 962-3419
Fax: (903) 385-3340
Type: Mailing
North Houston Street, Edgewood, Van Zandt County, Texas, 75117, United States
EDGEWOOD, TX 75117
Phone: (903) 962-3419
Fax: (903) 385-3340
Type: Location
409 COTTAGE RD
CARTHAGE, TX 756331466
Phone: (903) 694-4824
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 78 Open Payments records for all available years, with a total value of $1,339.
Total Amount is formed as General ($1,339) + Research ($0) + Ownership ($0) = $1,339.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($342).
Total Amount
$1,339
General + Research + Ownership
Payments
78
Total payment records
General Amount
$1,339
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $342 |
| AstraZeneca Pharmaceuticals LP | $151 |
| Novo Nordisk Inc | $105 |
| PFIZER INC. | $97 |
| Lilly USA, LLC | $81 |
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: 2004-08-02
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040802001049 | I | Nurse Practitioner | TX | TBD |
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.
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 75103)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | TX | 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 21 | 14 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX | |
| - | TX | |
| Family Practice | TX | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| - | AR | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX |
Reviews
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