Amanda L Shefchik, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2563-033 Issued in WI

Practice address

744 S Webster Ave FL 2
Green Bay, WI 54301-3505

Phone

(920) 433-3640

Fax

(920) 433-3716

NPI assigned

May 18, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Miss Amanda Lea Peot Former name

Medicare fee-for-service enrollment

Enrolled in WI, MI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oconto Hospital and Medical Center IncGroup PAC ID 2163461781, shared by 12 NPIs, 217 clinicians

Bellin Memorial Hospital IncGroup PAC ID 8820900749, shared by 10 NPIs, 685 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049
• Osf St Francis Hospital and Medical Group Hospital, Escanaba, MI, CCN 231337

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ashefchik924746@direct.emplifyhealth.org
• Direct secure messaging: ashefchik36839@direct.thedacare.org

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.

• Bellin Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473
  Medicare reassignment NPD
• Oconto Hospital & Medical Center Inc

  • Critical Access Hospital
  • Oconto, WI
  • NPI 1356373302
  Medicare reassignment NPD
• Bellin Memorial Hospital Inc

  • Cardiovascular Disease Physician
  • Crystal Falls, MI
  • NPI 1376649509
  Medicare reassignment NPD
• St. Francis Hospital

  • Obstetrics & Gynecology Physician
  • Escanaba, MI
  • NPI 1700828837
  Medicare reassignment NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390
  NPD
• Bellin Memorial Hospital Inc

  • Clinic/Center
  • Green Bay, WI
  • NPI 1497191951
  NPD
• Oconto Hospital & Medical Center Inc

  • Rural Health Clinic/Center
  • Suring, WI
  • NPI 1104418037
  NPD
• Oconto Hospital & Medical Center, Inc.

  • Rural Health Clinic/Center
  • Crivitz, WI
  • NPI 1174971725
  NPD
• St Francis Hospital

  • Anatomic Pathology & Clinical Pathology Physician
  • Escanaba, MI
  • NPI 1932206455
  NPD
• St. Francis Hospital

  • Family Medicine Physician
  • Escanaba, MI
  • NPI 1629011622

  Nurse Practitioner

  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Brillion, WI
  • NPI 1962464784
  NPD (past)
• Cardiology Associates of Green Bay, LTD

  • Cardiovascular Disease Physician
  • Green Bay, WI
  • NPI 1396824074
  NPD (past)

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

• Bellin Memorial Hospital Inc.

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1891740585
  Care Compare affiliation
• St Francis Hospital

  • Critical Access Hospital
  • Escanaba, MI
  • NPI 1922058551
  Care Compare affiliation

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299628800000",
    "number": "1336192707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE FL 2",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-433-3640",
            "fax_number": "920-433-3716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE FL 2",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-433-3640",
            "fax_number": "920-433-3716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEFCHIK",
        "first_name": "AMANDA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2011-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "134756-030",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "2563-033",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "134756-30",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41259200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "PEOT",
            "middle_name": "LEA",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristin M. Shaw, LPC
• Lisa Shaw, MSW, LCSW
• Paige Shaw
• Loryn Sheahan
• Andrea Sheedy, COTA
• Kim Marie Shefchik, PA-C
• Lisa Rae Shefchik, DC
• Marcia A. Shefchik, RN
• Nicole Marie Shefchik, M.S. CCC-SLP
• Steve A Shefchik, MA, LPC

• Nurse Practitioner in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; 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.

Verify at the official NPI Registry.