Tiffany Ann Shinnick

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209018490 Issued in IL

Practice address

1650 Midtown Rd
Peru, IL 61354-1200

Phone

(815) 220-2645

NPI assigned

Dec 26, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mendota Community Hospital 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Saint Paul Medical Center Hospital, Mendota, IL, CCN 141310
• Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
• Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233
• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mendota Community Hospital

  • Family Medicine Physician
  • Mendota, IL
  • NPI 1407872997

  IL

  Medicare reassignment Care Compare group NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527

  IL

  Medicare reassignment NPD
• Mendota Community Hospital

  • Rural Health Clinic/Center
  • Granville, IL
  • NPI 1225877590
  Care Compare group NPD
• Mendota Community Hospital

  • Rural Health Clinic/Center
  • Mendota, IL
  • NPI 1316320849
  Care Compare group
• Mendota Community Hospital

  • Rural Health Clinic/Center
  • Peru, IL
  • NPI 1376391888
  Care Compare group
• Mendota Community Hospital

  • Rural Health Clinic/Center
  • Peru, IL
  • NPI 1447029301
  Care Compare group
• Mendota Community Hospital

  • Critical Access Hospital
  • Mendota, IL
  • NPI 1609803113
  Care Compare group
• Mendota Community Hospital

  • Rural Health Clinic/Center
  • Spring Valley, IL
  • NPI 1750139267
  Care Compare group
• Mendota Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Mendota, IL
  • NPI 1922024843
  Care Compare group
• Mendota Community Hospital

  • Rural Health Clinic/Center
  • Oglesby, IL
  • NPI 1952159469
  Care Compare group
• Mendota Community Hospital

  • Emergency Medicine Physician
  • Mendota, IL
  • NPI 1417973900
  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mendota Community Hospital

  • Critical Access Hospital
  • Mendota, IL
  • NPI 1609803113

  Hospital

  Care Compare affiliation
• Ottawa Regional Hospital & Healthcare Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440

  Hospital

  Care Compare affiliation
• Saint Anthony Medical Center

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1790739977

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1003388463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 MIDTOWN RD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 MIDTOWN RD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541200",
            "telephone_number": "815-220-2645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINNICK",
        "first_name": "TIFFANY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-26",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Schwingle, MSW
• Kristina Selquist, M.S., CCC-SLP/L
• Timothy R Semlow, PT
• Michelle Serpico, APRN
• Kristie L Shin, PA-C
• Delinard Sibbaluca
• Moira Sibbaluca
• Katherine Elizabeth Siembab
• Spalding L Slevin IV, PT, CMPT
• Amy Lynn Smith, APN

• All providers in Peru, IL
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.