Shabori Shanae Smith

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2024014462 Issued in MO

Practice address

11125 Dunn Rd Ste 406
Saint Louis, MO 63136-6132

Phone

(314) 653-5484

NPI assigned

May 15, 2024

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1285664268
  Medicare reassignment Care Compare group NPD
• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Farmington, MO
  • NPI 1427114990
  NPD

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1053160747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11155 DUNN RD STE 406",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366150",
            "telephone_number": "314-653-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11125 DUNN RD STE 406",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366132",
            "telephone_number": "314-653-5484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11155 Dunn Rd Ste 406",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631366150",
            "country_code": "US",
            "telephone_number": "314-653-5484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHABORI",
        "middle_name": "SHANAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-15",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2024014462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11155 Dunn Rd Ste 109N",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631366148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sandra Smith
• Sandra Kay Smith, LPC
• Sarah Kendall Smith, MD
• Sarah T Smith, FNP-BC
• Sean E Smith, MD
• Shafonne Monique Smith, WHNP-BC
• Shannon Smith, MSW
• Sharon Smith
• Shayla Dana Smith
• Shaylynn Weststeyn Smith, AUD

• Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.