Individual provider Active NPI

Jennifer Shoemaker, RN

  • Infusion Therapy Registered Nurse
  • Lake Winnebago, MO
National Provider Identifier
1174484612
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Registered NurseTaxonomy code 163WI0500X
License
098596 Issued in MO
Practice address
110 Algonquin Dr
Lake Winnebago, MO 64034-9301
Phone
(816) 668-9499
NPI assigned
Nov 24, 2025
Last updated
Nov 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Registered Nurse 163WI0500X 098596 MO Primary

Addresses

Primary practice location

110 Algonquin Dr
Lake Winnebago, MO 64034-9301

Mailing address

110 Algonquin Dr
Lake Winnebago, MO 64034-9301
Phone (816) 668-9499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
098596MOMDInfusion Therapy Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1763942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1174484612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 ALGONQUIN DR",
            "city": "LAKE WINNEBAGO",
            "state": "MO",
            "postal_code": "640349301",
            "telephone_number": "816-668-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 ALGONQUIN DR",
            "city": "LAKE WINNEBAGO",
            "state": "MO",
            "postal_code": "640349301",
            "telephone_number": "816-668-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOEMAKER",
        "first_name": "JENNIFER",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-24",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "MO",
            "license": "098596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Winnebago, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.