Shannon Jackie Clark
Contractor β’ Vail, AZ
12729 S Ox Cart Trl
Vail, AZ 856419232
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
Practice Location & Contact Primary Location
12729 S Ox Cart Trl
Vail, AZ 856419232
What Public CMS Data Show
Contractor: NPPES taxonomy is a reported classification, not proof of board certification.
NPI first issued
2006
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, βDoes your provider accept Medicare as full payment?β
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Compared with the same specialty in Vail and Arizona
7 active clinicians are listed under Contractor with a practice address in Vail, AZ (333 in Arizona).
Addresses are self-reported to NPPES and may be out of date.
Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo Β· Report an error.
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2024-12-26NUCC Taxonomy Code: 171W00000X
A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering).
Additional State Medicaid & Healthcare Payer Identifiers
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
Registered at 12729 S OX CART TRL, VAIL, AZ 856419232 (Tel: 5122142841)
Registered at 12729 S OX CART TRL, VAIL, AZ 856419232 (Tel: 5122142841)
NPI status registered as active in NPPES database
Registered at 10750 S KNOLL CREST LN, TUCSON, AZ 857069052 (Tel: 5205742911)
Registered at 10750 S KNOLL CREST LN, TUCSON, AZ 857069052 (Tel: 5205742911)
Recorded as SHANNON CLARK
Contractor (license number reported to NPPES: AZ 11816)
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Mailing Address
12729 S Ox Cart Trl
Vail, AZ 856419232
Phone: 5122142841