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 25, 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
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

Secondary Practice Location 1

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

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Shannon Kennedy reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Texas enrollment
  • 1,246 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Nurse Practitioner (Family)
3667 COUNTY ROAD 2134 STE C
CADDO MILLS, TX 75135
Nurse Practitioner (Family)
3667 COUNTY ROAD 2134 STE C
CADDO MILLS, TX 75135
Nurse Practitioner (Family)
3667 COUNTY ROAD 2134 STE C
CADDO MILLS, TX 75135
Nurse Practitioner
3667 COUNTY ROAD 2134 STE C
CADDO MILLS, TX 75135

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.

Which organization bills Medicare for Shannon Kennedy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shannon Kennedy reassigns Medicare benefits to Signify Health Medical Associates, PLLC (Dallas, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shannon Kennedy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shannon Kennedy accept?

Health plans from Blue Cross and Blue Shield of Texas, Oscar Insurance Company and UnitedHealthcare 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 46 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.