{
"Npi": {
"NPI": "1013184266",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MEYERS",
"FirstName": "SHANNA",
"MiddleName": "M",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "ARNP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MCCAMMON",
"OtherFirstName": "SHANNA",
"OtherMiddleName": "A",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "APRN",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "2039 REGENCY RD STE 2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LEXINGTON",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "40503-2334",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "859-629-0484",
"MailingAddressFaxNumber": "859-545-4961",
"FirstLinePracticeLocationAddress": "2039 REGENCY ROAD SUITE 2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LEXINGTON",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "40503",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "859-629-0484",
"PracticeLocationAddressFaxNumber": "859-545-4961",
"EnumerationDate": "05/15/2008",
"LastUpdateDate": "09/17/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "3005617",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "363LA2100X",
"TaxonomyName": "Acute Care Nurse Practitioner",
"LicenseNumber": "3005617",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "3005617",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}