Shanell Rena Gladson, APRN

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

209031579 Issued in IL

Practice address

4615 Correl Ave
Bartonville, IL 61607-2618

Phone

(309) 453-0688

Fax

(309) 324-5977

NPI assigned

Mar 10, 2020

Last updated

Nov 16, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Mrs. Shanell Rena Reynolds-Gladson Professional name

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bespoke PsychiatryGroup PAC ID 3274951744, 51 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bespoke Psychiatry

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1952937104
  Medicare reassignment Care Compare group
• Shanell's Psychiatry Care

  • Nurse Practitioner
  • Bartonville, IL
  • NPI 1598649071

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763251200000",
    "number": "1043845084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4615 CORREL AVE",
            "city": "BARTONVILLE",
            "state": "IL",
            "postal_code": "616072618",
            "telephone_number": "309-453-0688",
            "fax_number": "309-324-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 CORREL AVE",
            "city": "BARTONVILLE",
            "state": "IL",
            "postal_code": "616072618",
            "telephone_number": "309-453-0688",
            "fax_number": "309-324-5977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2760 W Peoria Ave # 1115",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850295202",
            "country_code": "US",
            "telephone_number": "309-229-0799",
            "fax_number": "309-324-5977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLADSON",
        "first_name": "SHANELL",
        "middle_name": "RENA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-10",
        "last_updated": "2025-11-16",
        "certification_date": "2025-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN233341",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "04105255",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "23341",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "209031579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANELL",
            "last_name": "REYNOLDS-GLADSON",
            "middle_name": "RENA",
            "prefix": "MRS.",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jessica Kathryn Dean, D.M.D
• Lillian Marie Downing
• Dr. Jennifer R. Coverrdill, D.C.
• Patricia J Estep, CFNP
• Scott J Garvin, PHARMD
• Cassandra Rae Hake
• William C Hicok, M.D.
• Highland Park CVS, L.L.C. (CVS Pharmacy # 06446)
• James Horst, D.D.S.
• Joseph Frances Johnigk I, DC

• Psychiatry Physician in Bartonville, IL
• Providers in Bartonville, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2025; 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.