NPIMap

Individual provider Active NPI

Shannon M Sikorski, FNP-BC

  • Family Nurse Practitioner
  • Kennett, MO
National Provider Identifier
1275955494
Registry record updated Sep 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2013043969 Issued in MO
Practice address
1312 1St St
Kennett, MO 63857-2526
Phone
(573) 717-1080
Fax
(573) 888-3046
NPI assigned
Jan 7, 2014
Last updated
Sep 21, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2017

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 2013043969 MO Primary

Addresses

Primary practice location

1312 1St St
Kennett, MO 63857-2526

Mailing address

PO Box 728
Kennett, MO 63857-0728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140321000589 MO Practitioner - Nurse Practitioner 5193956860 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sikeston Emergency Group LLCGroup PAC ID 6305112814, 19 clinicians
Potosi Emergency Group, LLCGroup PAC ID 0648588541, 19 clinicians

Practice addresses (Care Compare)

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-1600

300 Health Way Dr
Potosi, MO 63664-1420
Phone (573) 438-5451

611 W Main St
Fredericktown, MO 63645-1111
Phone (573) 783-3341

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013043969MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iron County Hospital District CurrentSince Aug 1, 2025 Accepting new patients
Mercy Clinic Adult Hospitalists- Jefferson, LLC CurrentSince Dec 26, 2023 Accepting new patients
Southeastern Emergency Services of Memphis, P.C. CurrentSince Dec 10, 2023 Accepting new patients
Madison Medical Center Stockhoff Memorial Nursing Home CurrentSince Aug 4, 2014 Accepting new patients
Mercy Hospital Jefferson CurrentSince Aug 24, 2019 Accepting new patients
Sikeston Emergency Group LLC CurrentSince Oct 13, 2019 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC CurrentSince Jan 1, 2018 Accepting new patients
Iron County Hospital District CurrentSince Aug 1, 2025 Accepting new patients
Mercy Hospital Jefferson CurrentSince Aug 24, 2019 Accepting new patients
Madison Medical Center Stockhoff Memorial Nursing Home CurrentSince Aug 4, 2014 Accepting new patients
Potosi Emergency Group, LLC CurrentSince Feb 2, 2023 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Past Accepting new patients

Locations

7245 Raider Rd
Bonne Terre, MO 63628
Phone (573) 358-1400

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

1101 W Liberty St
Farmington, MO 63640
Phone (573) 705-1272

611 W Main St
Fredericktown, MO 63645
Phone (573) 773-7061

611 W Main St
Ste E
Fredericktown, MO 63645
Phone (573) 547-4899

300 Health Way Dr
Potosi, MO 63664
Phone (573) 438-2977

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

Interoperability endpoints

  • Direct secure messaging: shannon.sikorski.1@16878.direct.athenahealth.com
  • Direct secure messaging: ssikorski969390@directc.mercy.net

Organizations & group practices 12

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505952000000",
    "number": "1275955494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 728",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638570728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 1ST ST",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638572526",
            "telephone_number": "573-717-1080",
            "fax_number": "573-888-3046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIKORSKI",
        "first_name": "SHANNON",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-07",
        "last_updated": "2017-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2013043969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett, MO

Sources for this page

Verify at the official NPI Registry.