Natasha Charlyn Shafer, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Carbondale, IL
NPI 1023375409 · NPPES record last updated Sep 12, 2018
Key facts
- NPI
- 1023375409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2012006260 (MO)
- Practice address
- 1340 Cedar CT Ste 202
Carbondale, IL 62901 - Phone
- (618) 529-7821
- NPI assigned
- Apr 23, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Community Health and Emergency Services Inc
Practice addresses (Care Compare)
290 Railroad St
Tamms, IL 62988-5038
Phone (618) 747-2391
Hospital & facility affiliations
- Saint Francis Medical Center
- Memorial Hospital of Carbondale
- Deaconess Illinois Union County
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130326000155 | IL | Practitioner - Nurse Practitioner | 4486817376 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southernmost Illinois Community Health Improvement Corporation | Current | Accepting new patients | |
| Community Health & Emergency Services, Inc. | Current |
Accepting new patients | |
| Community Health & Emergency Services, Inc. | Past | Accepting new patients | |
| Community Health & Emergency Services, Inc. | Past | Accepting new patients |
Locations
13245 Kessler Rd
Cairo, IL 62914
Phone (618) 734-4400
1340 Cedar Ct
Carbondale, IL 62901
Phone (618) 457-7821
1340 Cedar Ct
Ste 202
Carbondale, IL 62901
Phone (618) 529-7821
290 Railroad St
Tamms, IL 62988
Phone (618) 253-8450
Interoperability endpoints
- natasha.shafer.p1@direct.chesi.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2012006260 | MO | Yes |
Addresses
Primary practice location
1340 Cedar CT Ste 202
Carbondale, IL 62901
Mailing address
1340 Cedar CT
Carbondale, IL 62901-5336
Phone (573) 472-6003
Other practice location 1
3111 Williamson County Pkwy
Marion, IL 62959-5235
Phone (618) 529-7821
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209010067 | Other | IL | DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION |
| 3903223660 | Other | THE FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION | |
| 2012001998 | Other | AMERICAN NURSES CREDENTIALING CENTER |
Other providers in Carbondale, IL
- Shelby Jo Seegers-Schafer
- Select Physical Therapy Holdings, Inc.
- Senior Adult Services
- Sensable Connections, PLLC
- Taylor Serrata
- Sonal Shah
- Awni Darweesh Shahait
- Carrie Shalosky
- Erick Allen Shannon
- Sarah Elizabeth Ruth Shannon
All providers in Carbondale, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.