Physician Compare National (NPI:1881644763)

HEALTHCARE PROVIDER: CLARINDA BURTON-SHANNON M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1881644763
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4688678725
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200508001635
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BURTON-SHANNON
	Individual professional last name
Provider First Name	CLARINDA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GENERAL PRACTICE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GENERAL PRACTICE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1405 W BADDOUR PKWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 105
	Group Practice or individual's line 2 address
City	LEBANON
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	370872568
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6159652467
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	440193
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TENNOVA HEALTHCARE-LEBANON
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y