Jennifer Dawn Shafer, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71004086A Issued in IN

Practice address

5604 E White Oak LN
Marengo, IN 47140-8413

Phone

(812) 365-3221

Fax

(812) 365-9502

NPI assigned

Aug 16, 2012

Last updated

Dec 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Harrison County HospitalGroup PAC ID 9032007208, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Harrison County Hospital Hospital, Corydon, IN, CCN 151331

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifershafer@sichc.allscriptsdirect.net

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.

• Harrison County Hospital

  dba Harrison County Hospital Physicians

  • Internal Medicine Physician
  • Corydon, IN
  • NPI 1790892727
  Medicare reassignment Care Compare group NPD
• Southern Indiana Community Health Care, Inc

  dba Comprehensive Health Care

  • Family Medicine Physician
  • Paoli, IN
  • NPI 1427171057
  Medicare reassignment NPD
• Harrison County Hospital

  dba After Hours Care

  • Rural Health Clinic/Center
  • Corydon, IN
  • NPI 1700779378
  NPD
• Southern Indiana Community Health Care, Inc

  dba Patoka Family Health Care

  • Family Medicine Physician
  • English, IN
  • NPI 1457474009
  NPD
• Harrison County Hospital

  dba Harrison Crawford Healthcare

  • Family Medicine Physician
  • Leavenworth, IN
  • NPI 1710093091
  NPD (past)
• Southern Indiana Community Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Orleans, IN
  • NPI 1356911390
  NPD (past)

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

• Harrison County Hospital

  dba Harrison County EMS

  • Ambulance
  • Corydon, IN
  • NPI 1073620001

  Hospital

  Care Compare affiliation
• Harrison County Hospital

  • General Acute Care Hospital
  • Corydon, IN
  • NPI 1427165455
  Care Compare affiliation
• Harrison County Hospital

  dba Harrison County EMS

  • Ambulance
  • Corydon, IN
  • NPI 1760599468

  Hospital

  Care Compare affiliation
• Harrison County Hospital

  • Critical Access Hospital
  • Corydon, IN
  • NPI 1851378137
  Care Compare affiliation

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1366790776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W LONGEST ST",
            "city": "PAOLI",
            "state": "IN",
            "postal_code": "474548821",
            "telephone_number": "812-723-3944",
            "fax_number": "812-723-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 E WHITE OAK LN",
            "city": "MARENGO",
            "state": "IN",
            "postal_code": "471408413",
            "telephone_number": "812-365-3221",
            "fax_number": "812-365-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "JENNIFER",
        "middle_name": "DAWN",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-16",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004086A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28168433A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201110950",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifershafer@sichc.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5604 E White Oak Ln",
            "city": "Marengo",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471408413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Howard D Detweiler, N. P.
• Engleking RX Marengo LLC (Engleking Rx)
• Jefferson Street Holdings LLC (The Little Green Door)
• Deborah J. Reichenbach, MDIV, MA
• Christi Lee Self, F.N.P.
• Southern Indiana Community Health Care, Inc (Crawford County Family Health Care)
• Southern Indiana Community Health Care, Inc (Crawford County Family Health Care)
• Susan Stein, N. P.
• Joni Stroudmartin, MA, LMHC, NCC
• Curtis Carlyle Thill, M. D.

• Family Nurse Practitioner in Marengo, IN
• Providers in Marengo, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.