Individual provider Active NPI

Shannen Ivey, APRN-CNP

  • Family Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1225856560
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
237081 Issued in LA
Practice address
1103 Kaliste Saloom Rd Ste 100
Lafayette, LA 70508-5784
Phone
(337) 234-5234
NPI assigned
Sep 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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 237081 LA Primary

Addresses

Primary practice location

1103 Kaliste Saloom Rd Ste 100
Lafayette, LA 70508-5784

Mailing address

1103 Kaliste Saloom Rd Ste 100
Lafayette, LA 70508-5784
Phone (337) 234-5234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20260602001520 LA Practitioner - Nurse Practitioner 5294206124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 1536
Mandeville, LA 70470

PO Box
Suite 51126
Lafayette, LA 70505-1126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
237081LAMDFamily Nurse Practitioner

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BHAJDD/Endpoint/BHAJDD

Organizations & group practices 1

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": "1727308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1225856560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 KALISTE SALOOM RD STE 100",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085784",
            "telephone_number": "337-234-5234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 KALISTE SALOOM RD STE 100",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085784",
            "telephone_number": "337-234-5234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVEY",
        "first_name": "SHANNEN",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-26",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "237081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.