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Individual provider Active NPI

Shannon L Feldman, APRN

  • Adult Health Clinical Nurse Specialist
  • Bloomington, IL
National Provider Identifier
1033559802
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
277000027 Issued in IL
Practice address
2103 E Washington St Ste 2C
Bloomington, IL 61701-4365
Phone
(309) 808-1450
Fax
(949) 561-4829
NPI assigned
Jun 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 277000027 IL Primary

Addresses

Primary practice location

2103 E Washington St Ste 2C
Bloomington, IL 61701-4365

Mailing address

2103 E Washington St Ste 2C
Bloomington, IL 61701-4365
Phone (309) 808-1450

Other practice location 1

501A S Towanda Barnes Rd Ste 2
Bloomington, IL 61705-4031
Phone (217) 784-4251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130731000576 IL Practitioner - Nurse Practitioner 1355360629 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

501 A S Towanda Barnes Rd
Suite 2
Bloomington, IL 61705-4031
Phone (217) 784-4251

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
277000027ILMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association CurrentSince Feb 1, 2026 Accepting new patients
Select Care PLLC CurrentSince Mar 31, 2021 Accepting new patients
Gibson Community Hospital Association CurrentSince Jan 1, 2013 Accepting new patients
Gibson Community Hospital Association CurrentSince Sep 1, 2025 Accepting new patients
Gibson Community Hospital Association CurrentSince Sep 1, 2025 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

501A S Towanda Barnes Rd
Ste 2
Bloomington, IL 61705
Phone (309) 612-9002

1015 S Mercer Ave
Ste E1
Bloomington, IL 61701
Phone (309) 662-7500

2200 E Washington St
Bloomington, IL 61701
Phone (309) 662-3311

2103 E Washington St
Ste 2C
Bloomington, IL 61701
Phone (309) 663-5810

1015 S Mercer Ave
Bloomington, IL 61701
Phone (309) 662-0088

7 Doctors Park
Gibson City, IL 60936
Phone (217) 784-5500

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

2005 Jacobssen Dr
Ste A
Normal, IL 61761
Phone (309) 807-2233

723 NE Glen Oak Ave
Peoria, IL 61603
Phone (309) 624-8749

Interoperability endpoints

  • Direct secure messaging: shannon.laesch.1@25313.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1033559802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 E WASHINGTON ST STE 2C",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617014365",
            "telephone_number": "309-808-1450",
            "fax_number": "949-561-4829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 E WASHINGTON ST STE 2C",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617014365",
            "telephone_number": "309-808-1450",
            "fax_number": "949-561-4829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501A S Towanda Barnes Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617054031",
            "country_code": "US",
            "telephone_number": "217-784-4251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FELDMAN",
        "first_name": "SHANNON",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "IL",
            "license": "277000027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.