Danielle Shadrach, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2020029486 Issued in MO

Practice address

1640 E Kearney St
Springfield, MO 65803-4106

Phone

(417) 863-9190

NPI assigned

Dec 2, 2019

Last updated

Dec 4, 2020By the provider in NPPES

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

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

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

• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1245277631
  Medicare reassignment NPD

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1053958678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 E KEARNEY ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658034106",
            "telephone_number": "417-863-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 E KEARNEY ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658034106",
            "telephone_number": "417-863-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADRACH",
        "first_name": "DANIELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020029486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shane A. Severns, CRNA
• Kelli Sexton
• Nycolle Sexton, PA-C
• SFFD LLC
• Sgoh Acquisition Inc
• James T Shaeffer, M.D.
• Elizabeth Anne Shaffer, MD
• Jennifer R Shaffer, MSW, LCSW
• Richard Dwight Shaffer, M.D.
• Amit Shah, MD

• Family Nurse Practitioner in Springfield, MO
• Providers in Springfield, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.