Shayla Amos, MD
Individual provider Active NPI Family Medicine Physician · Fort Leonard Wood, MO
NPI 1124759774 · NPPES record last updated Apr 17, 2026
Key facts
- NPI
- 1124759774
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 97874 (GA)
- Practice address
- 4234 Illinois Ave
Fort Leonard Wood, MO 65473-9098 - Phone
- (573) 596-1765
- NPI assigned
- Jun 23, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240105000556 | GA | Order and Referring Only - Family Practice |
2062863830 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 97874 | GA | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 97874 | GA | Yes |
Addresses
Primary practice location
4234 Illinois Ave
Fort Leonard Wood, MO 65473-9098
Mailing address
4234 Illinois Ave
Fort Leonard Wood, MO 65473-9098
Phone (573) 596-1765
Other providers in Fort Leonard Wood, MO
- Darrin Alexander
- Mustafa Mohamed Alikhan
- Benjamin Althuisius
- Diana Alvarado
- Zeinab Ahmed Ammar
- Corinna Lynn Anderson
- Michael Anderson
- Rachel Morgan Armstrong
- Erica L Asbell
- Nathan B Asbell
All providers in Fort Leonard Wood, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.