Shanon Erin Caillier, CNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Crookston, MN
NPI 1295564938 · NPPES record last updated Jul 31, 2024
Key facts
- NPI
- 1295564938
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 11875 (MN)
- Practice address
- 18336 260TH St SW
Crookston, MN 56716 - Phone
- (218) 289-2787
- NPI assigned
- Jul 31, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mille Lacs Health System
Warren Community Hospital Inc
Practice addresses (Care Compare)
200 Elm St N
Onamia, MN 56359-7901
300 W Good Samaritan Dr
Warren, MN 56762-1412
Phone (218) 745-4211
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN, IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241028002574 | MN | Practitioner - Nurse Practitioner | 4880127950 | Reassigns benefits to 3 organizations |
| I20241224000712 | IA | Practitioner - Nurse Practitioner | 4880127950 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11875 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mille Lacs Health System | Current |
Accepting new patients | |
| Mille Lacs Health System | Current |
Accepting new patients | |
| Mille Lacs Health System | Current | Accepting new patients | |
| Serene Sunrise Mental Health Clinic | Psychiatric/Mental Health | Current | Accepting new patients |
| Warren Community Hospital, Inc. | Current |
Accepting new patients | |
| Evizzit of Iowa Psychiatry PC | Psychiatric/Mental Health | Current |
Accepting new patients |
Locations
1501 42nd St
Ste 575
West Des Moines, IA 50266
Phone 8552703625171
200 Elm St N
Onamia, MN 56359
Phone (320) 532-2750
300 W Good Samaritan Dr
Warren, MN 56762
Phone (218) 745-4211
8 Cadillac Dr
Ste 230
Brentwood, TN 37027
Phone (615) 647-0750
Interoperability endpoints
- shanon.caillier.1@31765.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 11875 | MN | Yes |
Addresses
Primary practice location
18336 260TH St SW
Crookston, MN 56716
Mailing address
18336 260TH St SW
Crookston, MN 56716-9410
Phone (218) 289-2787
Other practice location 1
300 W Good Samaritan Dr
Warren, MN 56762-1412
Phone (218) 745-4211
Other names
- Shanon Erin Caillier
Other providers in Crookston, MN
- Lorelle Rose Brun
- Janet Ann Burger
- Danell Sue Burgess
- Beth Hariette Burnette
- Oliver Buseth
- Calming Waters Therapy PLLC
- Angela Marie Carlson
- Jeanette Diane Carlson
- Mary Lou Carlson
- Eileen M Channel
All providers in Crookston, MN · Psychiatric/Mental Health Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.