Individual provider Active NPI

Donna F Shellenberger, RN

  • Home Health Registered Nurse
  • Eau Claire, WI
National Provider Identifier
1366600652
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
131260030 Issued in WI
Practice address
4939 Kappus Dr
Eau Claire, WI 54701-2910
Phone
(715) 864-1033
NPI assigned
May 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 131260030 WI Primary

Addresses

Primary practice location

4939 Kappus Dr
Eau Claire, WI 54701-2910

Mailing address

4939 Kappus Dr
Eau Claire, WI 54701-2910
Phone (715) 864-1033

Other identifiers 1

IdentifierTypeStateIssuer
35016900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
131260030WIMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1366600652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4939 KAPPUS DR",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547012910",
            "telephone_number": "715-864-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4939 KAPPUS DR",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547012910",
            "telephone_number": "715-864-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLENBERGER",
        "first_name": "DONNA",
        "middle_name": "F",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "131260030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35016900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.