Audrey Claire Shilander, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

DO2547 Issued in NV

Practice address

1100 N College Ave
Fayetteville, AR 72703-1944

Phone

(479) 443-4301

NPI assigned

Mar 25, 2015

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

• Audrey Claire Jensen Former name

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Stark Medicine McKay Khurana Jeider PLLCGroup PAC ID 1557601978, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• Stark Medicine McKay Khurana Jeider PLLC

  • Child & Adolescent Psychiatry Physician
  • Las Vegas, NV
  • NPI 1053880856
  Medicare reassignment Care Compare group
• Psychiatry Services Professional Corporation Khurana Jeider

  • Psychiatry Physician
  • Las Vegas, NV
  • NPI 1225887375
  NPD
• Unlv Medicine

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1407397235
  NPD (past)

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1053705293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5935 FRANCES AVE NE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984221430",
            "telephone_number": "532-948-6879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031944",
            "telephone_number": "479-443-4301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "840 S Rancho Dr # 4-903",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891063837",
            "country_code": "US",
            "telephone_number": "702-440-8430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHILANDER",
        "first_name": "AUDREY",
        "middle_name": "CLAIRE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-25",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "DO2547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "JENSEN",
            "middle_name": "CLAIRE",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Janie Linda Sherwood, CRNA
• Patrick W Shewmaker
• Shields Therapy LLC
• Abbey Breanna Shields, APRN
• Xochitl Shields
• Shiloh Health and Longevity
• Holly Shinn, RN/MHPP
• Mary Teresa Shinn, MD
• Randy J Shinn, MD
• Diana L Shipman, MD

• Psychiatry Physician in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Psychiatry Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.