JACQUELINE A SHANNON
NPI 1730651696
Counselor - Professional in Fort Worth, TX
About Jacqueline A Shannon NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACQUELINE A SHANNON (NPI 1730651696) is an individual professional provider in Fort Worth, Texas, licensed in Texas (76758) and active in the NPI registry since December 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2015).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jacqueline A Shannon 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.
Medicare Billing Reassignment
Medicare enrollment records show Jacqueline Shannon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fort Worth, TX 76107
- Reassigned Medicare billing, Texas enrollment
- 165 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.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FORT WORTH, TX 76107
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 Jacqueline Shannon's NPI number?
The NPI number for Jacqueline Shannon is 1730651696. It was assigned to this individual provider in the NPPES registry on December 17, 2018.
Where is Jacqueline Shannon located?
Jacqueline Shannon practices at 3840 Hulen St, Fort Worth, TX 76107. The listed phone number is (817) 335-3022.
What is Jacqueline Shannon's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Jacqueline Shannon enrolled in Medicare?
Yes. Jacqueline Shannon 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.
Which organization bills Medicare for Jacqueline Shannon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Shannon reassigns Medicare benefits to My Health My Resources Of Tarrant County (Fort Worth, 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 Jacqueline Shannon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jacqueline Shannon 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 3 other insurers list Jacqueline Shannon 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 Jacqueline Shannon was last updated on February 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Jacqueline A Shannon · NPI 1730651696
Professional provider in Fort Worth, Texas. Individual provider, active in the CMS NPPES registry since December 17, 2018.
## Identity
- **NPI:** 1730651696 (Entity type: Individual)
- **Enumerated:** December 17, 2018
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 76758 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 3840 HULEN ST, Fort Worth, TX 76107-7277
- **Phone:** (817) 335-3022
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** My Health My Resources Of Tarrant County (NPI 1952423782, Fort Worth, TX), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2015
## Record status
- **NPPES last updated:** February 8, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1730651696) · Data from the CMS NPPES public registry.