Shellie Kathleen Faris, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2007007765 Issued in MO

Practice address

2016 S Main St
Maryville, MO 64468-2655

Phone

(660) 562-2525

Fax

(660) 562-4303

NPI assigned

Apr 26, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

University of Nebraska College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Mary Lanning Memorial Hospital AssociationGroup PAC ID 4587575550, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mary Lanning Healthcare Hospital, Hastings, NE, CCN 280032

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• The Mary Lanning Memorial Hospital Association

  • Family Medicine Physician
  • Hastings, NE
  • NPI 1356656417
  Medicare reassignment Care Compare group
• Hastings Family Practice, P.C

  • Family Medicine Physician
  • Hastings, NE
  • NPI 1356383756
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Mary Lanning Memorial Hospital Association

  • Clinical Medical Laboratory
  • Hastings, NE
  • NPI 1205442258

  Hospital

  Care Compare affiliation
• The Mary Lanning Memorial Hospital Association

  • Rural Acute Care Hospital
  • Hastings, NE
  • NPI 1831203488
  Care Compare affiliation

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1174743884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E SOUTH HILLS DR",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682659",
            "telephone_number": "660-562-2525",
            "fax_number": "660-562-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 S MAIN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682655",
            "telephone_number": "660-562-2525",
            "fax_number": "660-562-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARIS",
        "first_name": "SHELLIE",
        "middle_name": "KATHLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2007007765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912965328",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206341000",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emergency Practice Associates, Inc.
• Madison Emery, LMSW
• Megan Epperly
• Pamela L Euler
• Kevan James Evans, D.C.
• Jeff Farnan
• Terra R Feick, PLPC
• John Michael Feuerbacher, M.D.
• Charles S Fillingane II, DO
• Lisa Finney, FNP-C

• Surgery Physician in Maryville, MO
• Providers in Maryville, MO by specialty
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.