Alexis R Shimboff

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

020017455 Issued in IL

Practice address

225 Richmond Ave E Ste B
Mattoon, IL 61938-4651

Phone

(217) 235-0800

NPI assigned

Mar 20, 2026

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

Other names 1

• Alexis R Beals Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Sarah Bush Lincoln Health Center

  • Dental Clinic/Center
  • Mattoon, IL
  • NPI 1114198744
  NPD (past)
• Sarah Bush Lincoln Health Center

  • Critical Access Hospital
  • Vandalia, IL
  • NPI 1912988734
  NPD (past)

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

{
    "created_epoch": "1773964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1023966264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 RICHMOND AVE E STE B",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 RICHMOND AVE E STE B",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384651",
            "telephone_number": "217-235-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMBOFF",
        "first_name": "ALEXIS",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-20",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "IL",
            "license": "020017455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "BEALS",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Shanley, M.S.
• Morgan Shaw, RSA
• Cari Shepherd, RSA
• Penelope Shields, NP
• Zachary Ryan Shields, PA-C
• Macy Shupe, BA
• Matthew Samuel Siambanes
• Andrea M Sias, CRNA
• Jennifer Jo Sides
• Carlos Rafael Sierra-Rodriguez, M.D.

• All providers in Mattoon, IL
• Dental Hygienist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.