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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SHANNON KELLY KENNEDY FNP-C
NPI 1457080228
Nurse Practitioner - Family in Caddo Mills, TX

Active since June 07, 2022PECOS Enrolled
3667 COUNTY ROAD 2134 STE C, CADDO MILLS, TX 75135(903) 751-5550(833) 973-3638 Get Directions Write a Review

NPPES record last updated: September 14, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 14, 2026, Feb 11, 2025, Feb 3, 2025 and 2 more (5 updates tracked since 2022).

About Shannon Kelly Kennedy Fnp-c NPPES

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

SHANNON KELLY KENNEDY FNP-C (NPI 1457080228) is an individual family provider in Caddo Mills, Texas, licensed in Texas (1088162) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS and maintains a secondary practice location in Rockwall.

NPPES Registry Identity

NPI1457080228
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHANNON KELLY KENNEDYCredential: FNP-C
Location Address3667 COUNTY ROAD 2134 STE CCaddo Mills, TX 75135-6897
Mailing Address3667 County Road 2134 Ste CCaddo Mills, TX 75135-6897 · (903) 751-5550 · Fax (833) 973-3638
Phone(903) 751-5550
Fax(833) 973-3638
Sole ProprietorNo
Enumeration DateJune 7, 2022
Last NPPES UpdateSeptember 14, 20265 updates tracked since enumeration
NPPES CertifiedSeptember 14, 2026
✔ NPI 1457080228 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TX · 1088162
3667 COUNTY ROAD 2134 STE C, Caddo Mills, TX 75135
Open in Google Maps ↗

Secondary Practice Location 1

Location 12504 Ridge Rd Ste 203Rockwall, TX 75087-2571 · Phone (469) 887-5550 · Fax (833) 973-3638

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannon Kelly Kennedy Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75135 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

Other Providers at the Same Location NPPES 4

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

GUISELLE BERRY FNP-C
Nurse Practitioner (Family)
3667 COUNTY ROAD 2134 STE C
CADDO MILLS, TX 75135
Hunt County (903) 751-5550
COURTNEY PATRICK NP
Nurse Practitioner (Family)
3667 COUNTY ROAD 2134 STE C
CADDO MILLS, TX 75135
Hunt County (903) 751-5550
REVIVE FAMILY CARE & WELLNESS LLC
Nurse Practitioner (Family)
3667 COUNTY ROAD 2134 STE C
CADDO MILLS, TX 75135
Hunt County (903) 751-5550
MONICA BOOKER FNP
Nurse Practitioner
3667 COUNTY ROAD 2134 STE C
CADDO MILLS, TX 75135
Hunt County (903) 751-5550

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 Kennedy's NPI number?

The NPI number for Shannon Kennedy is 1457080228. It was assigned to this individual provider in the NPPES registry on June 7, 2022.

Where is Shannon Kennedy located?

Shannon Kennedy practices at 3667 County Road 2134 Ste C, Caddo Mills, TX 75135. The listed phone number is (903) 751-5550.

What is Shannon Kennedy's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shannon Kennedy enrolled in Medicare?

Yes. Shannon Kennedy is registered in the Medicare PECOS enrollment system.

What insurance does Shannon Kennedy accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Shannon Kennedy 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 Kennedy was last updated on September 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 days 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.