NPIMap

Individual provider Active NPI

Shannon M Mentzer, ARNP

  • Family Nurse Practitioner
  • Davenport, IA
National Provider Identifier
1184957839
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A088931 Issued in IA
Practice address
1236 E Rusholme St
Suite 300
Davenport, IA 52803-2434
Phone
(563) 324-2992
Fax
(563) 324-8562
NPI assigned
Sep 14, 2009
Last updated
Feb 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A088931 IA Primary

Addresses

Primary practice location

1236 E Rusholme St
Suite 300
Davenport, IA 52803-2434

Mailing address

1236 E Rusholme St
Suite 300
Davenport, IA 52803-2434
Phone (563) 324-2992

Other names 1

  • Shannon M Woolard Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shannon.mentzerarnp.p1@direct.cvmedpc.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100116000296 IA Practitioner - Nurse Practitioner 4981746716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Medicine PLLCGroup PAC ID 2264334721, 50 clinicians

Practice addresses (Care Compare)

1236 E Rusholme St
Suite 300
Davenport, IA 52803-2473
Phone (563) 324-2992

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.95 of 100Reported as group
Quality
70.54
Promoting interoperability
97
Improvement activities
40
Cost
75.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
088931IAMDAthletic Trainer
A088931IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Cardiovascular Medicine PLLC CurrentSince Oct 10, 2009 Accepting new patients

Locations

1236 E Rusholme St
Ste 300
Davenport, IA 52803
Phone (319) 324-2992

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: smentzer92370@direct.unitypoint.org

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1184957839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 E RUSHOLME ST",
            "address_2": "SUITE 300",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032434",
            "telephone_number": "563-324-2992",
            "fax_number": "563-324-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 E RUSHOLME ST",
            "address_2": "SUITE 300",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032434",
            "telephone_number": "563-324-2992",
            "fax_number": "563-324-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENTZER",
        "first_name": "SHANNON",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-14",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A088931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shannon.mentzerarnp.p1@direct.cvmedpc.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1236 E Rusholme St",
            "address_2": "Suite 300",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528032434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "WOOLARD",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.