Individual provider Active NPI

Lynn M Shima, APN

  • Acute Care Nurse Practitioner
  • Hannibal, MO
National Provider Identifier
1063489441
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2007029013 Issued in MO
Practice address
6500 Hospital Dr
Hannibal, MO 63401-6890
Phone
(573) 629-3300
Fax
(573) 629-3314
NPI assigned
Mar 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 674323 TX
Acute Care Nurse Practitioner 363LA2100X 2007029013 MO Primary

Addresses

Primary practice location

6500 Hospital Dr
Hannibal, MO 63401-6890

Mailing address

6500 Hospital Dr
Hannibal, MO 63401-6890
Phone (573) 629-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20191112003314 TX Practitioner - Nurse Practitioner 7719179019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
674323TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Clinic of Longview PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lynn.shima@hca7.eclinicaldirectplus.com
  • FHIR API: https://api.platform.athenahealth.com/23550/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1063489441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 HOSPITAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016890",
            "telephone_number": "573-629-3300",
            "fax_number": "573-629-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 HOSPITAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016890",
            "telephone_number": "573-629-3300",
            "fax_number": "573-629-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMA",
        "first_name": "LYNN",
        "middle_name": "M",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "674323",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2007029013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.