Individual provider Active NPI

Shannon B. Gleason, APRN

  • Family Nurse Practitioner
  • Owensboro, KY
National Provider Identifier
1366095820
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3013549 Issued in KY
Practice address
1030A Burlew Blvd
Owensboro, KY 42303-1735
Phone
(270) 926-2273
Fax
(270) 684-3212
NPI assigned
Jul 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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 3013549 KY Primary

Addresses

Primary practice location

1030A Burlew Blvd
Owensboro, KY 42303-1735

Mailing address

PO Box 1919
Owensboro, KY 42302-1919
Phone (270) 926-2273

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190821000466 KY Practitioner - Nurse Practitioner 7012245632 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Owensboro Health, IncGroup PAC ID 0547154650, shared by 9 NPIs, 179 clinicians
Premier Medical Group PSCGroup PAC ID 7517868235, 5 clinicians
Owensboro Health Medical Group IncGroup PAC ID 0648255034, 455 clinicians

Practice addresses (Care Compare)

1006 Ford Ave
Owensboro, KY 42301-4677
Phone (270) 688-4845

1030 A Burlew Blvd
Owensboro, KY 42303-1735
Phone (270) 926-2273

1030 Burlew Blvd
Suite a
Owensboro, KY 42303-2057
Phone (270) 926-2273

Hospital & facility affiliations

  • Caresouth HHA Holdings of Winchester, LLC Dba Enhabit Home Health Home health agency, Owensboro, KY, CCN 187087
  • Owensboro Health Regional Hospital Hospital, Owensboro, KY, CCN 180038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3013549KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group Inc Family CurrentSince Jan 7, 2024 Accepting new patients
Physicians Affiliated Care, PSC CurrentSince Jul 1, 2023 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Premier Medical Group, PSC Family CurrentSince Jul 1, 2023 Accepting new patients

Locations

1030 Burlew Blvd
Ste A
Owensboro, KY 42303
Phone (270) 926-2273

Interoperability endpoints

  • Direct secure messaging: sgleason98075@direct.owensborohealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1366095820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1919",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423021919",
            "telephone_number": "270-926-2273",
            "fax_number": "270-684-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030A BURLEW BLVD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031735",
            "telephone_number": "270-926-2273",
            "fax_number": "270-684-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "SHANNON",
        "middle_name": "B.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.