Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shannon Fullen-Roberts

Individual provider Family Nurse Practitioner · NPI 1245645118

Shannon Fullen-Roberts is a Nurse Practitioner in Abingdon, Virginia. Qualified in 2009, 17 years ago. Practices with Blue Ridge Medical Management Corporation, a 286-clinician group, works from 8 locations, accepts Medicare assignment and offers telehealth. Licensed in Tennessee and Virginia.

Years since qualifying
17
Licensed in
TN, VA
In the registry since
2014
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

16000 Johnston Memorial Dr Ste 212A
Abingdon, VA 24211-7664
Phone: (276) 258-3740
Fax: (276) 258-3745
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (7)

  • 1 Medical Park Blvd, Bristol, TN 37620-7430 — (423) 844-1121
  • 1 Medical Park Blvd Ste 210e, Bristol, TN 37620-7468 — (423) 844-5500
  • 1 Medical Park Blvd Ste 3w, Bristol, TN 37620-7430 — (423) 844-5583
  • 2202 N John B Dennis Hwy Ste 110, Kingsport, TN 37660-5904 — (423) 578-8400
  • 2000 Brookside Dr, Kingsport, TN 37660-4627 — (423) 857-7000
  • 130 W Ravine Rd, Kingsport, TN 37660-3837 — (423) 224-4000
  • 98 15th St Nw Ste 207, Norton, VA 24273-1600 — (276) 439-1490

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 0024171744 (VA)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 25249 (TN)

Record details

NPI number1245645118
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 30, 2014
Last updated in NPPESMarch 13, 2024
Certification dateMarch 13, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Blue Ridge Medical Management Corporation — 286 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Abingdon