Individual provider Active NPI

Shawn Marie Myhre, CNP

  • Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1205861622
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CP000458 Issued in SD
Practice address
3415 N Potsdam Ave
Sioux Falls, SD 57104-7017
Phone
(605) 338-2066
Fax
(605) 371-3754
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CP000458 SD Primary

Addresses

Primary practice location

3415 N Potsdam Ave
Sioux Falls, SD 57104-7017

Mailing address

3415 N Potsdam Ave
Sioux Falls, SD 57104-7017
Phone (605) 338-2066

Other identifiers 1

IdentifierTypeStateIssuer
6826292MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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

Enrollment IDStateProvider typePAC IDDetails
I20070221000649 SD Practitioner - Nurse Practitioner 9133221120 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CP000458SDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heart Hospital of South Dakota LLC CurrentSince Sep 1, 2016 Accepting new patients
Heart Hospital of South Dakota LLC CurrentSince Sep 1, 2016 Accepting new patients
Orthopedic Institute PC Past Accepting new patients
Compassionate Care Hospice of the Midwest, LLC Past Accepting new patients

Locations

4500 W 69th St
Sioux Falls, SD 57108
Phone (605) 977-7000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1205861622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 N POTSDAM AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571047017",
            "telephone_number": "605-338-2066",
            "fax_number": "605-371-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 N POTSDAM AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571047017",
            "telephone_number": "605-338-2066",
            "fax_number": "605-371-3754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYHRE",
        "first_name": "SHAWN",
        "middle_name": "MARIE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "CP000458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6826292",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.