Active NPI
Shelby Brewer
- Nurse Practitioner
- Charleston, IL
National Provider Identifier
1407499189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209020042
- Practice address
- 25 W Lincoln Ave
Charleston, IL 61920-3070 - Phone
- (217) 345-9600
- Fax
- (217) 345-3045
- NPI assigned
- Oct 24, 2019
- Last updated
- Oct 6, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209020042 | IL | Primary |
Addresses
Primary practice location
25 W Lincoln Ave
Charleston, IL 61920-3070
Mailing address
25 W Lincoln Ave
Charleston, IL 61920-3070
Phone (217) 345-9600
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601942400000",
"number": "1407499189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 W LINCOLN AVE",
"city": "CHARLESTON",
"state": "IL",
"postal_code": "619203070",
"telephone_number": "217-345-9600",
"fax_number": "217-345-3045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 W LINCOLN AVE",
"city": "CHARLESTON",
"state": "IL",
"postal_code": "619203070",
"telephone_number": "217-345-9600",
"fax_number": "217-345-3045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREWER",
"first_name": "SHELBY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-24",
"last_updated": "2020-10-06",
"certification_date": "2020-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209020042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, IL
- Katherine Ruth Blesch, PA-C
- Jacob Benjamin Blount, MSN, APRN, FNP-C
- Board of Trustees for Eastern Illinois University (Eastern Il University Pharmacy)
- Abigail Elizabeth Bonnstetter
- Jerry L. Boyd, PH.D.
- Bright Minds Educational Program Inc
- Brinkerhoff Counseling LLC
- Amanda J Brinkerhoff, LCPC
- Kaleb Lee Brown, DC
- Garrett B Buell, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.