Elizabeth Shallenberger, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

277005812 Issued in IL

Practice address

803 N 1St St
Vienna, IL 62995-1544

Phone

(618) 658-2811

Fax

(618) 833-6267

NPI assigned

Sep 18, 2018

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

Medicare fee-for-service enrollment

Enrolled in IL, MO2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elizabeth.shallenberger.1@27782.direct.athenahealth.com

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.

• Deaconess Illinois Union County Hospital Inc

  dba Deaconess Illinois Rural Health Clinic Anna

  • Rural Health Clinic/Center
  • Anna, IL
  • NPI 1184340408

  Nurse Practitioner

  Medicare reassignment NPD
• Rural Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Anna, IL
  • NPI 1982666384
  Medicare reassignment NPD
• Southeast Missouri Hospital Physicians, LLC

  dba Mercy Clinic Southeast

  • Family Medicine Physician
  • Cape Girardeau, MO
  • NPI 1558311522
  Medicare reassignment NPD
• Rural Health, Inc.

  dba Rural Health Plus

  • Community/Retail Pharmacy
  • Anna, IL
  • NPI 1801634183
  NPD
• Rural Health, Inc.

  dba Dongola Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Dongola, IL
  • NPI 1366506628
  NPD (past)
• Deaconess Union County Hospital, Inc

  • Critical Access Hospital
  • Morganfield, KY
  • NPI 1497320519
  NPD (past)

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1104300094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 CEDAR GROVE RD",
            "city": "BUNCOMBE",
            "state": "IL",
            "postal_code": "629122052",
            "telephone_number": "618-201-5926",
            "fax_number": "618-833-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 N 1ST ST",
            "city": "VIENNA",
            "state": "IL",
            "postal_code": "629951544",
            "telephone_number": "618-658-2811",
            "fax_number": "618-833-6267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "513 N Main St",
            "address_purpose": "LOCATION",
            "city": "Anna",
            "state": "IL",
            "postal_code": "629061697",
            "country_code": "US",
            "telephone_number": "618-833-4471",
            "fax_number": "618-833-6267",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "211 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Goreville",
            "state": "IL",
            "postal_code": "629392323",
            "country_code": "US",
            "telephone_number": "618-995-1002",
            "fax_number": "618-833-6267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHALLENBERGER",
        "first_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018052",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209018052",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277005812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ebone Ross, MPA, QMHP
• David Rudy, BS, MHP
• Rural Health, Inc. (Vienna Medical Clinic)
• Rachel Marie Rushing, APRN
• Casey Sanders, BA MHP
• Diana Shipley
• William Skiles
• Jesse Smith-Fulia, LCSW
• Melissa Smith, BSW, MHP
• Emilie St. Peter, MSW QMHP

• Family Nurse Practitioner in Vienna, IL
• Providers in Vienna, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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.