SHANNON HILLEY NP
NPI 1013411065
Nurse Practitioner in Fort Payne, AL

Active since March 22, 2018PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
2605 GAULT AVE N STE 200, FORT PAYNE, AL 35967(256) 997-2855 Get Directions Write a Review

NPPES record last updated: February 18, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 18, 2021, Mar 22, 2018 (2 updates tracked since 2018).

About Shannon Hilley Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON HILLEY NP (NPI 1013411065) is an individual nurse practitioner in Fort Payne, Alabama, licensed in Alabama (1-092758) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1013411065
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameSHANNON HILLEYCredential: NP
Location Address2605 GAULT AVE N STE 200Fort Payne, AL 35967-3700
Mailing Address2605 Gault Ave N Ste 200Fort Payne, AL 35967-3700 · (256) 979-1550 · Fax (256) 979-1576
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateMarch 22, 2018
Last NPPES UpdateFebruary 18, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 18, 2021
NPI 1013411065 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in AL · 1-092758
Definition
(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.
2605 GAULT AVE N STE 200, Fort Payne, AL 35967

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Shannon Hilley Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113275918
PECOS Enrollment IDI20180810001817
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 19

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
474 services80 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
275 services185 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
185 services116 patients
Injection, ketorolac tromethamine, per 15 mg J1885
Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.
148 services82 patients
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702
This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
141 services43 patients
X-ray of knee, 1-2 views 73560
An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.
135 services85 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35967 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%851 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
41%231 patients2/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%281 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
10%894 patients1/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%894 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
1%894 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
3%894 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Standard wheelchair K0001
DME-Wheelchairs · category DD000N
2 suppliers16 claims16 services$21.57 avg. paid by Medicare
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment L1820
DME-Orthotic Devices · category DF011N
1 supplier14 claims14 services$101.16 avg. paid by Medicare
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf L4361
DME-Orthotic Devices · category DF003N
1 supplier17 claims17 services$215.40 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Durable Medical Equipment & Medical Supplies
2605 GAULT AVE N STE 200
FORT PAYNE, AL 35967
Nurse Practitioner (Family)
2605 GAULT AVE N STE 200
FORT PAYNE, AL 35967
Nurse Practitioner
2605 GAULT AVE N STE 200
FORT PAYNE, AL 35967
Physician Assistant
2605 GAULT AVE N STE 200
FORT PAYNE, AL 35967
Nurse Practitioner (Family)
2605 GAULT AVE N STE 200
FORT PAYNE, AL 35967

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Hilley's NPI number?

The NPI number for Shannon Hilley is 1013411065. It was assigned to this individual provider in the NPPES registry on March 22, 2018.

Where is Shannon Hilley located?

Shannon Hilley practices at 2605 Gault Ave N Ste 200, Fort Payne, AL 35967. The listed phone number is (256) 997-2855.

What is Shannon Hilley's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Shannon Hilley enrolled in Medicare?

Yes. Shannon Hilley is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shannon Hilley accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama, Ambetter of Tennessee and Blue Cross and Blue Shield of Alabama and 1 other insurer list Shannon Hilley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shannon Hilley was last updated on February 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.