Active NPI
Shannon Elton, NURSE PRACTITIONER
- Nurse Practitioner
- Willmar, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R1296428
- Practice address
- Affiliated Community Medical Centers
101 Willmar Ave SW
Willmar, MN 56201 - Phone
- (320) 231-5000
- Fax
- (320) 231-5079
- NPI assigned
- Nov 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R1296428 | MN | Primary |
Addresses
Primary practice location
Affiliated Community Medical Centers
101 Willmar Ave SW
Willmar, MN 56201
Mailing address
Affiliated Community Medical Centers
101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Centracare Health-Paynesville LLC
Practice addresses (Care Compare)
101 Willmar Ave SW
Willmar, MN 56201-3556
Phone (320) 231-5000
200 W 1St St
Paynesville, MN 56362-1445
Phone (320) 243-3767
600 Peterson Pkwy
New London, MN 56273-7823
Phone (320) 354-2222
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1296428 | MN | MD | Nurse Practitioner |
| 448 | MN | MD | Obstetrics & Gynecology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centracare Clinic Southwest LLC | Current | Accepting new patients | |
| Centracare Clinic Southwest LLC | Current | Accepting new patients |
Locations
600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222
101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079
Interoperability endpoints
- selton29686@direct.centracare.com
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Willmar, MN
- NPI 1174106264
-
- Durable Medical Equipment & Medical Supplies
- Willmar, MN
- NPI 1912664889
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Willmar, MN
- NPI 1407367030
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245300250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "AFFILIATED COMMUNITY MEDICAL CENTERS",
"address_2": "101 WILLMAR AVE SW",
"city": "WILLMAR",
"state": "MN",
"postal_code": "56201",
"telephone_number": "320-231-5079",
"fax_number": "320-231-5067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "AFFILIATED COMMUNITY MEDICAL CENTERS",
"address_2": "101 WILLMAR AVE SW",
"city": "WILLMAR",
"state": "MN",
"postal_code": "56201",
"telephone_number": "320-231-5000",
"fax_number": "320-231-5079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELTON",
"first_name": "SHANNON",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "R1296428",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Willmar, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.