Shannon Vanderkooi, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO-06509 Issued in IA

Practice address

1101 9TH St SE
Sioux Center, IA 51250-2501

Phone

(712) 722-1271

NPI assigned

Apr 6, 2021

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 names 1

• Shannon Vander Berg Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sioux Center HealthGroup PAC ID 9032027495, shared by 6 NPIs, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sioux Center Health Home Care and Hospice Hospice, Sioux Center, IA, CCN 161519
• Sioux Center Health Hospital, Sioux Center, IA, CCN 161346
• Crown Pointe Estates Care Center Nursing home, Sioux Center, IA, CCN 165157

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.vanderkooi@avera.sdhealthlink.net

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.

• Sioux Center Health

  • Critical Access Hospital
  • Sioux Center, IA
  • NPI 1326056755
  Medicare reassignment NPD
• Sioux Center Health

  • Critical Access Hospital
  • Sioux Center, IA
  • NPI 1669542981
  Medicare reassignment NPD
• Sioux Center Health

  • Family Medicine Physician
  • Hawarden, IA
  • NPI 1225507510
  NPD
• Sioux Center Health

  • Family Medicine Physician
  • Sioux Center, IA
  • NPI 1558494138
  NPD

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

• Sioux Center Health

  • Critical Access Hospital
  • Sioux Center, IA
  • NPI 1326056755
  Care Compare affiliation
• Sioux Center Health

  • Nursing Facility/Intermediate Care Facility
  • Sioux Center, IA
  • NPI 1518080019

  Nursing home

  Care Compare affiliation
• Sioux Center Health

  • Community Based Hospice Care Agency
  • Sioux Center, IA
  • NPI 1932279254
  Care Compare affiliation

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1225617103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 9TH ST SE",
            "city": "SIOUX CENTER",
            "state": "IA",
            "postal_code": "512502501",
            "telephone_number": "712-722-1271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 9TH ST SE",
            "city": "SIOUX CENTER",
            "state": "IA",
            "postal_code": "512502501",
            "telephone_number": "712-722-1271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERKOOI",
        "first_name": "SHANNON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-06509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "VANDER BERG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Anne Vande Hoef, DPT
• Heather Vande Kieft, PHARMD
• Kathryn Vander Veen, M.S.N., A.P.R.N.
• Kristi Lynn Vander Veen, PTA
• Jacie Elaine Vander Waal
• Kathleen Maureen Vantol
• Mark Vanvuuren
• Kristi Lou Vos
• Wal-Mart Stores, Inc.
• Walmart Inc.

• Family Medicine Physician in Sioux Center, IA
• Providers in Sioux Center, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.