Individual provider Active NPI

Shannon Nicole Marsden, MD

  • Family Medicine Physician
  • West Plains, MO
National Provider Identifier
1053792259
Registry record updated May 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2015016244 Issued in MO
Practice address
1307 Porter Wagoner Blvd
West Plains, MO 65775-1828
Phone
(417) 255-8645
NPI assigned
Jun 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2015016244 MO Primary

Addresses

Primary practice location

1307 Porter Wagoner Blvd
West Plains, MO 65775-1828

Mailing address

1423 N Jefferson Ave Ste B100
Springfield, MO 65802-1917
Phone (417) 269-8817

Other practice location 1

180 S Kentucky Ave
West Plains, MO 65775-2082
Phone (417) 256-7078

Other identifiers 1

IdentifierTypeStateIssuer
200050408MedicaidMO

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180714000100 MO Practitioner - Family Practice 5496002990 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ozarks Medical CenterGroup PAC ID 3870491863, 166 clinicians

Practice addresses (Care Compare)

1100 N Kentucky Ave
West Plains, MO 65775-2029

Hospital & facility affiliations

  • Ozarks Healthcare at Home, Home Health Home health agency, West Plains, MO, CCN 267186
  • Ozarks Healthcare Hospital, West Plains, MO, CCN 260078

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as group
Quality
78.58
Promoting interoperability
99
Improvement activities
40
Cost
77.82

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2015016244MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center CurrentSince Sep 15, 2024 Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

1100 N Kentucky Ave
West Plains, MO 65775
Phone (417) 257-5959

Networks

  • IA HMO

Organizations & group practices 3

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748217600000",
    "number": "1053792259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 N JEFFERSON AVE STE B100",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658021917",
            "telephone_number": "417-269-8817",
            "fax_number": "417-269-8744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 PORTER WAGONER BLVD",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657751828",
            "telephone_number": "417-255-8645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 S Kentucky Ave",
            "address_purpose": "LOCATION",
            "city": "West Plains",
            "state": "MO",
            "postal_code": "657752082",
            "country_code": "US",
            "telephone_number": "417-256-7078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSDEN",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2025-05-26",
        "certification_date": "2025-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2015016244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200050408",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Plains, MO

Sources for this page

Verify at the official NPI Registry.