Shawnee Lynn Kellison, RNBCFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

113721 Issued in MO

Practice address

700 W Jefferson St
Kirksville, MO 63501-1441

Phone

(660) 626-2191

Fax

(660) 626-2396

NPI assigned

Nov 21, 2005

Last updated

Feb 2, 2026By 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 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2026 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

• Putnam County Memorial Hospital

  • Critical Access Hospital
  • Unionville, MO
  • NPI 1609870195
  NPD
• Cleaver Dermatology PC

  • Dermatology Physician
  • Kirksville, MO
  • NPI 1013452861
  NPD (past)
• Kirksville Missouri Hospital Company LLC

  dba Family Health Center of Edina

  • Rural Health Clinic/Center
  • Edina, MO
  • NPI 1346215944
  NPD (past)

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1063495463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W JEFFERSON ST",
            "address_2": "PO BOX 7545",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635011441",
            "telephone_number": "660-626-2191",
            "fax_number": "660-626-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W JEFFERSON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635011441",
            "telephone_number": "660-626-2191",
            "fax_number": "660-626-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLISON",
        "first_name": "SHAWNEE",
        "middle_name": "LYNN",
        "credential": "RNBCFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "113721",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A153236",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MO",
            "license": "113721",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "DG4290",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00435145",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "000014853",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428713812",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP #",
            "identifier": "501218200",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlin Alexis Hannah Kauff
• KB Kirksville Pharmacy LLC (Kirksville Pharmacy)
• KB Kirksville Pharmacy LLC (Kirksville Pharmacy)
• Karlin E Kean, LMSW
• Brenda Kay Kelley, PTA
• Kelly D. Burchett DO LLC (Advanced Surgical Arts)
• Deann Kelly, RDH, OMT
• Levi A Kelly, CRNA
• Matthew Dean Kelly
• Kathleen M Kelso, RN

• Family Nurse Practitioner in Kirksville, MO
• Providers in Kirksville, 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 Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.