Shanon K Luke, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2021020969 Issued in MO

Practice address

1109 W Clay Rd
Versailles, MO 65084-1177

Phone

(573) 378-2351

Fax

(866) 208-0157

NPI assigned

Jun 27, 2021

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

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Regional Health Care Clinic Inc

  dba Katy Trail Community Health

  • Federally Qualified Health Center (FQHC)
  • Sedalia, MO
  • NPI 1922057504
  Medicare reassignment NPD
• Regional Health Care Clinic, Inc

  dba Katy Trail - Prairie Hills

  • Federally Qualified Health Center (FQHC)
  • Versailles, MO
  • NPI 1053694422
  Medicare reassignment NPD
• Regional Health Care Clinic Inc

  dba Katy Trail Community Health Warsaw

  • Federally Qualified Health Center (FQHC)
  • Warsaw, MO
  • NPI 1053533539
  NPD
• Regional Health Care Clinic, Inc

  dba Katy Trail - Warsaw School

  • Federally Qualified Health Center (FQHC)
  • Warsaw, MO
  • NPI 1629797196
  NPD
• Regional Health Care Clinic, Inc

  dba Katy Trail Community Health

  • Federally Qualified Health Center (FQHC)
  • Stover, MO
  • NPI 1952655862
  NPD (past)
• Regional Health Care Clinic, Inc.

  dba Katy Trail Community Health

  • Federally Qualified Health Center (FQHC)
  • Sedalia, MO
  • NPI 1700532306
  NPD (past)

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

{
    "created_epoch": "1624752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1255901898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 W MAIN ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653013821",
            "telephone_number": "660-826-4774",
            "fax_number": "866-208-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 W CLAY RD",
            "city": "VERSAILLES",
            "state": "MO",
            "postal_code": "650841177",
            "telephone_number": "573-378-2351",
            "fax_number": "866-208-0157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "821 WESTWOOD DR",
            "address_purpose": "LOCATION",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012102",
            "country_code": "US",
            "telephone_number": "660-826-4774",
            "fax_number": "866-208-0157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUKE",
        "first_name": "SHANON",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-27",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2021020969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Kloeppel
• Sunshine Lafoy
• Laurie Pharmacy Inc (Senior Pharmacy)
• Sylvia Lawson-Cook, LCSW
• Colin Lepley, PTA
• Destiny Almajo Maben, COTA/L
• Hanna Michels, PT
• Morgan County Health Center
• Morgan County Targeted Case Management
• Morning Song Isl Services LLC

• Pediatrics Physician in Versailles, MO
• Providers in Versailles, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.