Individual provider Active NPI

Shawntey I Bailey-Hudson

  • Adult Health Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1093558256
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F307638 Issued in NY
Practice address
5075 W Seneca Tpke
Syracuse, NY 13215-3216
Phone
(888) 256-3814
NPI assigned
Jun 17, 2024
Last updated
Jul 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F307638 NY Primary

Addresses

Primary practice location

5075 W Seneca Tpke
Syracuse, NY 13215-3216

Mailing address

1100 NW South Outer Rd Ste 200
Blue Springs, MO 64015-3069
Phone (888) 256-3814

Other practice location 1

10976 209th Pl
Queens Village, NY 11429-1763
Phone (347) 423-9337

Other practice location 2

1100 NW South Outer Rd Ste 200
Blue Springs, MO 64015-3069
Phone (888) 256-3814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240912000736 NY Practitioner - Nurse Practitioner 4486194875 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senf NP Family Medicine PLLCGroup PAC ID 0648637991, 57 clinicians

Practice addresses (Care Compare)

10421 State Route 40
Granville, NY 12832-5713
Phone (443) 383-9300

67 Springvale Rd
Croton on Hudson, NY 10520-1343
Phone (443) 383-9300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New York State Medical Health Services PC CurrentSince Oct 1, 2025 Accepting new patients
Senf NP Family Medicine PLLC CurrentSince Oct 20, 2025 Accepting new patients
Wound Care Plus, LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

909 Ridgebrook Rd
Ste 300
Sparks Glencoe, MD 21152
Phone (443) 483-9300

1100 NW South Outer Rd
Ste 200
Blue Springs, MO 64015
Phone (888) 256-3514

4240 Blue Ridge Blvd
Ste 530
Kansas City, MO 64133
Phone (816) 291-4601

67 Springvale Rd
Croton on Hudson, NY 10520
Phone (914) 739-6700

301 Nantucket Dr
Endicott, NY 13760
Phone (607) 754-2700

11126 Corona Ave
Flushing, NY 11368
Phone (718) 592-6400

7144 Yellowstone Blvd
Forest Hills, NY 11375
Phone (718) 544-4300

10421 State Route 40
Ste 300
Granville, NY 12832

301 Mill Rd
Ste U5
Hewlett, NY 11557

5075 W Seneca Tpke
Syracuse, NY 13215
Phone (315) 435-5511

50 Main St
Ste 1000
White Plains, NY 10606
Phone (914) 216-7550

50 Main St
Ste 10000
White Plains, NY 10606

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1093558256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 NW SOUTH OUTER RD STE 200",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640153069",
            "telephone_number": "888-256-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5075 W SENECA TPKE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132153216",
            "telephone_number": "888-256-3814"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10976 209th Pl",
            "address_purpose": "LOCATION",
            "city": "Queens Village",
            "state": "NY",
            "postal_code": "114291763",
            "country_code": "US",
            "telephone_number": "347-423-9337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 NW South Outer Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Blue Springs",
            "state": "MO",
            "postal_code": "640153069",
            "country_code": "US",
            "telephone_number": "888-256-3814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILEY-HUDSON",
        "first_name": "SHAWNTEY",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.