JACQUELINE A SHANNON
NPI 1730651696
Counselor - Professional in Fort Worth, TX

Active since December 17, 2018PECOS EnrolledAccepts Medicare Assignment
3840 HULEN ST, FORT WORTH, TX 76107(817) 335-3022 Get Directions Write a Review

NPPES record last updated: February 8, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 8, 2019, Dec 17, 2018 (2 updates tracked since 2018).

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

NPI1730651696
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameJACQUELINE A SHANNON
Location Address3840 HULEN STFort Worth, TX 76107-7277
Mailing Address3840 Hulen StFort Worth, TX 76107-7277 · (817) 569-4300
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateDecember 17, 2018
Last NPPES UpdateFebruary 8, 20192 updates tracked since enumeration
NPI 1730651696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in TX · 76758
Also ListedCounselor · SchoolTaxonomy 101YS0200X · License 76758 (TX)
3840 HULEN ST, Fort Worth, TX 76107

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

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.

PECOS PAC ID1355855750
PECOS Enrollment IDI20250708003559
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.

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.

Dietitian, Registered
3840 HULEN ST
FORT WORTH, TX 76107
Counselor (Addiction (Substance Use Disorder))
3840 HULEN ST
FORT WORTH, TX 76107
Occupational Therapist
3840 HULEN ST
FORT WORTH, TX 76107
Registered Nurse
3840 HULEN ST
FORT WORTH, TX 76107
Social Worker
3840 HULEN ST
FORT WORTH, TX 76107
Registered Nurse
3840 HULEN ST
FORT WORTH, TX 76107
Registered Nurse
3840 HULEN ST
FORT WORTH, TX 76107
Registered Nurse
3840 HULEN ST
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.

What insurance does Jacqueline Shannon accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 5 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.