Individual provider Active NPI

Natasha Charlyn Shafer, FNP-BC

  • Family Nurse Practitioner
  • Carbondale, IL
National Provider Identifier
1023375409
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2012006260 Issued in MO
Practice address
1340 Cedar CT Ste 202
Carbondale, IL 62901
Phone
(618) 529-7821
NPI assigned
Apr 23, 2012
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2012006260 MO Primary

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

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130326000155 IL Practitioner - Nurse Practitioner 4486817376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

290 Railroad St
Tamms, IL 62988-5038
Phone (618) 747-2391

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health & Emergency Services, Inc. CurrentSince Dec 19, 2012 Accepting new patients
Southernmost Illinois Community Health Improvement Corporation 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

  • Direct secure messaging: natasha.shafer.p1@direct.chesi.nextgenshare.com

Organizations & group practices 4

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

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1023375409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 CEDAR CT",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015336",
            "telephone_number": "573-472-6003",
            "fax_number": "573-472-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 CEDAR CT STE 202",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "62901",
            "telephone_number": "618-529-7821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3111 Williamson County Pkwy",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629595235",
            "country_code": "US",
            "telephone_number": "618-529-7821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "NATASHA",
        "middle_name": "CHARLYN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012006260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.