Shannon Tisdell, FNP in Olive Branch, MS - Medicare Nurse Practitioner

Shannon Tisdell, FNP is a medicare enrolled "Nurse Practitioner - Family" in Olive Branch, Mississippi. She graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Ut Regional One Physicians Inc and her current practice location is 6674 Goodman Rd, Olive Branch, Mississippi. You can reach out to her office (for appointments etc.) via phone at (662) 985-7806.

Shannon Tisdell is licensed to practice in Mississippi (license number 904149) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1790384329.

Contact Information

	Shannon Tisdell, FNP
	6674 Goodman Rd, Olive Branch, MS 38654-7056
	(662) 985-7806
	Not Available

Map and Direction

Provider's Profile

Full Name	Shannon Tisdell
Gender	Female
Speciality	Nurse Practitioner
Experience	4 Years
Location	6674 Goodman Rd, Olive Branch, Mississippi
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Shannon Tisdell graduated from nursing school in 2020

NPI Data:

NPI Number: 1790384329
Provider Enumeration Date: 10/24/2020
Last Update Date: 10/24/2020

Medicare PECOS Information:

PECOS PAC ID: 1254744527
Enrollment ID: I20210218000825

Medical Identifiers

Medical identifiers for Shannon Tisdell such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1790384329	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	904149 (Mississippi)	Primary
363LF0000X	Nurse Practitioner - Family	27722 (Tennessee)	Secondary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Ut Regional One Physicians Inc	5698993418	277

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shannon Tisdell allows following entities to bill medicare on her behalf.

Entity Name	Ut Regional One Physicians Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1093130585 PECOS PAC ID: 5698993418 Enrollment ID: O20140820000662

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shannon Tisdell is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Shannon Tisdell, FNP 7587 Wisteria Dr, Olive Branch, MS 38654-6982 Ph: (662) 313-7520	Shannon Tisdell, FNP 6674 Goodman Rd, Olive Branch, MS 38654-7056 Ph: (662) 985-7806

Reviews and Comments

Nurse Practitioner Nurses in Olive Branch, MS

Carolyn Wong, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4064 Sidlehill Dr, Olive Branch, MS 38654 Phone: 601-842-9006
Brittany Nikita Carper, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6674 Goodman Rd, Olive Branch, MS 38654 Phone: 662-985-7806
Jennifer C Sanders, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5480 Goodman Rd Ste 1, Olive Branch, MS 38654 Phone: 662-874-6507 Fax: 662-932-8197
Mrs. Misty Moore Ivy, C.R.N.P. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7203 Goodman Rd, Olive Branch, MS 38654 Phone: 901-759-2322
Wanda Brown, WHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4240 Bethel Rd Ste 101, Olive Branch, MS 38654 Phone: 662-932-9544 Fax: 662-932-9554
Kori Swearengen, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 9075 Sandidge Center Cv, Olive Branch, MS 38654 Phone: 662-895-4949 Fax: 662-895-6776
Queen Mcghee, APN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4250 Bethel Rd, Olive Branch, MS 38654 Phone: 662-932-9111

Shannon Tisdell, FNP - Medicare Nurse Practitioner in Olive Branch, MS