DR. JACKY DWAYNE SHANNON M.D. NPI 1265510218

NPI Information

  • NPI: 1265510218
  • Provider Name: DR. JACKY DWAYNE SHANNON, M.D.
  • Classification: Anesthesiology - 207LC0200X
  • Specialization: Critical Care Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3601 4TH ST
    LUBBOCK, TX
    ZIP 79430
  • Phone: (806) 743-2981

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NPI Details

DR. Jacky Dwayne Shannon, M.D. is a critical care medicine anesthesiology in Lubbock, TX with 24 years of experience. The provider is an anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. DR. Jacky Dwayne Shannon, M.D. NPI is 1265510218. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Graduation Year:2002

The provider's business location address is:

3601 4TH ST
LUBBOCK, TX
ZIP 79430-002
Phone: (806) 743-2981

The NPI 1265510218 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Critical care, first 30-74 minutes (HCPCS:99291)
  • Follow-up hospital inpatient care per day, typically 35 minutes (HCPCS:99233)
  • Initial hospital inpatient care per day, typically 50 minutes (HCPCS:99222)
  • Follow-up hospital inpatient care per day, typically 15 minutes (HCPCS:99231)

The enumeration date for this NPI number is 11/1/2006 and was last updated on 11/30/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207L00000XAnesthesiologyL8505TEXASNo
2207LC0200XAnesthesiologyCritical Care MedicineL8505TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1L8505OTHERTEXASMEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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