Shannon Marie Boelow

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

887854 Issued in NV

Practice address

5590 Kietzke LN
Reno, NV 89511-3019

Phone

(775) 323-2080

NPI assigned

Mar 20, 2025

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

Medicare fee-for-service enrollment

Enrolled in NV

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

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sierra Neurosurgery GroupGroup PAC ID 3870588619, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Renown Regional Medical Center Hospital, Reno, NV, CCN 290001
• Tahoe Forest Hospital Hospital, Truckee, CA, CCN 051328
• Renown South Meadows Medical Center Hospital, Reno, NV, CCN 290049
• Banner Churchill Community Hospital Hospital, Fallon, NV, CCN 291313

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.boelow.1@13729.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/13729/brand/6/csg/1/fhir/r4

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.

• Sierra Neurosurgery Group

  • Neurological Surgery Physician
  • Reno, NV
  • NPI 1295914661
  Medicare reassignment Care Compare group NPD
• Sierra Neurosurgery Group

  • Neurological Surgery Physician
  • Sparks, NV
  • NPI 1396492492
  NPD

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

• Banner Churchill Community Hospital

  • Critical Access Hospital
  • Fallon, NV
  • NPI 1265811251
  Care Compare affiliation
• Renown Regional Medical Center

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1124098421
  Care Compare affiliation
• Renown Regional Medical Center

  • General Acute Care Hospital
  • Sparks, NV
  • NPI 1932517299
  Care Compare affiliation
• Renown South Meadows Medical Center

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1720058027
  Care Compare affiliation
• Tahoe Forest Hospital District

  • Critical Access Hospital
  • Truckee, CA
  • NPI 1538265780
  Care Compare affiliation

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

{
    "created_epoch": "1742428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1225839822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5590 KIETZKE LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113019",
            "telephone_number": "775-323-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5590 KIETZKE LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113019",
            "telephone_number": "775-323-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOELOW",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-20",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "887854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Body Wisdom Physical Therapy
• Amanda Jo Boe
• Leah Boe, LADC, MFT INTERN
• McKenna Boegle
• Noah Boekweg
• Richard Neil Boersig, LCSW
• Jessica Boesen
• Phillip Bradley Boeye, LCSW-C
• Evelyn Bogarin Hurtado
• Robert W Bogart, DO

• Nurse Practitioner in Reno, NV
• Providers in Reno, NV by specialty
• Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.