Shannon Peterson, DNP, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A112768 Issued in IA

Practice address

1501 E 10TH St
Atlantic, IA 50022-1936

Phone

(712) 243-2850

Fax

(712) 243-7423

NPI assigned

Jul 23, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Nurse Practitioner

Education

Creighton University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cass County Memorial HospitalGroup PAC ID 5294634994, 67 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cass County Memorial Hospital Hospital, Atlantic, IA, CCN 161376
• Cass County Memorial Hospital Nursing home, CCN 16Z376

Merit-based Incentive Payment System (MIPS)

Final score

67.8 of 100Reported as group

Quality

85.99

Promoting interoperability

96

Improvement activities

40

Cost

10

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cass County Memorial Hospital

  • Critical Access Hospital
  • Atlantic, IA
  • NPI 1093760944

  IA

  Medicare reassignment Care Compare group NPD
• Cass County Memorial Hospital

  • Critical Access Hospital
  • Atlantic, IA
  • NPI 1861597122

  IA

  Medicare reassignment Care Compare group NPD
• Cass County Memorial Hospital

  • Community/Retail Pharmacy
  • Atlantic, IA
  • NPI 1023755097
  Care Compare group NPD
• Cass County Memorial Hospital

  • Rural Health Clinic/Center
  • Atlantic, IA
  • NPI 1699976696
  Care Compare group NPD
• Cass County Memorial Hospital

  • Optometrist
  • Atlantic, IA
  • NPI 1043747280
  Care Compare group
• Cass County Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Atlantic, IA
  • NPI 1134143696
  Care Compare group
• Cass County Memorial Hospital

  • Family Medicine Physician
  • Atlantic, IA
  • NPI 1316148307
  Care Compare group
• Cass County Memorial Hospital

  • Rural Health Clinic/Center
  • Massena, IA
  • NPI 1447451331
  Care Compare group
• Cass County Memorial Hospital

  • Rural Health Clinic/Center
  • Atlantic, IA
  • NPI 1649471699
  Care Compare group

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

• Cass County Memorial Hospital

  • Critical Access Hospital
  • Atlantic, IA
  • NPI 1093760944

  Hospital

  Care Compare affiliation
• Cass County Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Atlantic, IA
  • NPI 1134143696

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1215345210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E 10TH ST",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "500221936",
            "telephone_number": "712-243-2850",
            "fax_number": "712-243-7423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E 10TH ST",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "500221936",
            "telephone_number": "712-243-2850",
            "fax_number": "712-243-7423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SHANNON",
        "credential": "DNP, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-23",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A112768",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IA",
            "license": "H112768",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell Lee Peerbolte, D.C.
• Ronald L Peerbolte, D.C
• Andrew Prall Perina, PHARMD.
• Amy Suzette Petersen, APRN
• Shawn Ray Petersen, D.D.S
• Kieu Diem Pham
• Physician Management Services of Iowa, LLC
• Physiotherapy Associates Inc
• Dianna Marie Prokupek, ARNP
• Justina R Reeves, TCADC

• All providers in Atlantic, IA
• Family Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.