Aireal Shasaundai Bishop, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

2020041038 Issued in MO

Practice address

12800 Boenker LN
Bridgeton, MO 63044-2438

Phone

(314) 467-8506

Fax

(314) 467-8506

NPI assigned

Jun 10, 2021

Last updated

Feb 23, 2023By 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.

• Yam Medical Center LLC

  • General Practice Physician
  • Bridgeton, MO
  • NPI 1568072650
  Medicare reassignment NPD

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1114594736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12800 BOENKER LN",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442438",
            "telephone_number": "314-467-8506",
            "fax_number": "314-467-8506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 BOENKER LN",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442438",
            "telephone_number": "314-467-8506",
            "fax_number": "314-467-8506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "AIREAL",
        "middle_name": "SHASAUNDAI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2020041038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Biomedical Imaging LLC
• Biomedical Imaging LLC
• Biomedical Imaging LLC
• Bryant Biondo
• Anne Clair Bisch, APRN, BC
• Samantha Bixby
• BJC Behavioral Health
• Alexander H Black
• Madison Blackburn, PT, DPT
• Spencer Blondeaux

• Gerontology Nurse Practitioner in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Gerontology Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.