Sharandell Rena Wallace

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2015022803 Issued in MO

Practice address

605 SW US Highway 40 # 146
Blue Springs, MO 64014-3232

Phone

(816) 479-1426

NPI assigned

Mar 18, 2026

Last updated

Mar 18, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healing at the Root LLC

  • Licensed Practical Nurse
  • Blue Springs, MO
  • NPI 1316542749
  NPD Authorized official
• Prestige Home Health Care L.L.C

  • Home Health Agency
  • Independence, MO
  • NPI 1437790227

  Licensed Practical Nurse

  NPD

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

{
    "created_epoch": "1773792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1235087008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 SW US HIGHWAY 40 # 146",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640143232",
            "telephone_number": "816-479-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 SW US HIGHWAY 40 # 146",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640143232",
            "telephone_number": "816-479-1426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SHARANDELL",
        "middle_name": "RENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-18",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "2015022803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East LP (WalMart Pharmacy 10-5149)
• Wal-Mart Stores East, LP (Vision Center 30-0184)
• Walgreen Co (Walgreens #07789)
• Walgreen Co (Walgreens #04225)
• Joyce R Wallace, PHD
• Nataly Angela Leyva Ward
• Tammy Warson
• Waterford Village LP (Waterford LadiesHome)
• Summer Waters, RDH
• Britney Waterworth

• Licensed Practical Nurse in Blue Springs, MO
• Providers in Blue Springs, MO by specialty
• Licensed Practical Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.