SHANNON TISDELL FNP
NPI 1790384329
Nurse Practitioner - Family in Olive Branch, MS

Active since October 24, 2020PECOS EnrolledAccepts Medicare Assignment
75.06/100
CMS Quality Rating
6674 GOODMAN RD, OLIVE BRANCH, MS 38654(662) 985-7806 Get Directions Write a Review

NPPES record last updated: October 24, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shannon Tisdell Fnp NPPES

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

SHANNON TISDELL FNP (NPI 1790384329) is an individual family provider in Olive Branch, Mississippi, licensed in Mississippi (904149) and active in the NPI registry since October 2020. She is enrolled in Medicare PECOS, is affiliated with Regional One Health, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1790384329
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHANNON TISDELLCredential: FNP
Location Address6674 GOODMAN RDOlive Branch, MS 38654-7056
Mailing Address7587 Wisteria DrOlive Branch, MS 38654-6982 · (662) 313-7520
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateOctober 24, 2020
NPPES CertifiedOctober 24, 2020
NPI 1790384329 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
Licenses Licensed in MS · 904149 Licensed in TN · 27722
6674 GOODMAN RD, Olive Branch, MS 38654

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 Tisdell Fnp 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 ID1254744527
PECOS Enrollment IDI20210218000825
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Regional One Health

Acute Care Hospitals · Memphis, TN
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number440152
Location877 Jefferson AvenueMemphis, TN 38103 · Shelby County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38654 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
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
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.

75.06/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality56.46
Improvement Activities40
Cost71.87

Other Providers at the Same Location NPPES 3

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

Nurse Practitioner (Family)
6674 GOODMAN RD
OLIVE BRANCH, MS 38654
Durable Medical Equipment & Medical Supplies
6674 GOODMAN RD
OLIVE BRANCH, MS 38654
Nurse Practitioner (Family)
6674 GOODMAN RD
OLIVE BRANCH, MS 38654

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 Tisdell's NPI number?

The NPI number for Shannon Tisdell is 1790384329. It was assigned to this individual provider in the NPPES registry on October 24, 2020.

Where is Shannon Tisdell located?

Shannon Tisdell practices at 6674 Goodman Rd, Olive Branch, MS 38654. The listed phone number is (662) 985-7806.

What is Shannon Tisdell's specialty?

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

Is Shannon Tisdell enrolled in Medicare?

Yes. Shannon Tisdell 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 Tisdell accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 3 other insurers list Shannon Tisdell 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.

Is Shannon Tisdell affiliated with any hospitals?

According to CMS data, Shannon Tisdell is affiliated with Regional One Health.

When was this NPI record last updated?

The NPPES record for Shannon Tisdell was last updated on October 24, 2020. 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.