Individual provider Active NPI

Melissa M Shands, FNP-BC

  • Family Nurse Practitioner
  • Perryville, MO
National Provider Identifier
1417308362
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016020300 Issued in MO
Practice address
212 Hospital LN Ste 202
Perryville, MO 63775-4204
Phone
(573) 768-3449
NPI assigned
Jun 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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 2016020300 MO Primary

Addresses

Primary practice location

212 Hospital LN Ste 202
Perryville, MO 63775-4204

Mailing address

17921 BCR 262
Sedgewickville, MO 63781-3023
Phone (573) 301-3435

Other practice location 1

1508 Edgemont Blvd
Perryville, MO 63775-1231
Phone (573) 768-3220

Other practice location 2

212 Hospital Ln Ste 101A
Perryville, MO 63775-4204
Phone (573) 547-7888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20160711000071 MO Practitioner - Nurse Practitioner 7810289964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital PerryGroup PAC ID 1153777826, 115 clinicians

Practice addresses (Care Compare)

1508 Edgemont Blvd
Primary Care/Convenient Care
Perryville, MO 63775-1231
Phone (573) 768-3220

Hospital & facility affiliations

  • Mercy Hospital Perry Hospital, Perryville, MO, CCN 261311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2016020300MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Perry CurrentSince Oct 1, 2023 Accepting new patients
Mercy Hospital Perry CurrentSince Oct 1, 2023 Accepting new patients
Mercy Hospital Perry Current Accepting new patients
Mercy Hospital Perry Past Accepting new patients

Locations

434 N West St
Perryville, MO 63775
Phone (573) 547-2530

206 Hospital Ln
Ste 201
Perryville, MO 63775
Phone (573) 547-4899

1508 Edgemont Blvd
Perryville, MO 63775
Phone (573) 339-2000

212 Hospital Ln
Ste 101A
Perryville, MO 63775
Phone (573) 547-7888

212 Hospital Ln
Ste 202
Perryville, MO 63775
Phone (573) 331-3333

212 Hospital Ln
Ste 101
Perryville, MO 63775
Phone (573) 547-7888

212 Hospital Ln
Ste 200
Perryville, MO 63775
Phone (573) 768-3410

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 1

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": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1417308362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17921 BCR 262",
            "city": "SEDGEWICKVILLE",
            "state": "MO",
            "postal_code": "637813023",
            "telephone_number": "573-301-3435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 HOSPITAL LN STE 202",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637754204",
            "telephone_number": "573-768-3449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1508 Edgemont Blvd",
            "address_purpose": "LOCATION",
            "city": "Perryville",
            "state": "MO",
            "postal_code": "637751231",
            "country_code": "US",
            "telephone_number": "573-768-3220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "212 Hospital Ln Ste 101A",
            "address_purpose": "LOCATION",
            "city": "Perryville",
            "state": "MO",
            "postal_code": "637754204",
            "country_code": "US",
            "telephone_number": "573-547-7888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANDS",
        "first_name": "MELISSA",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016020300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perryville, MO

Sources for this page

Verify at the official NPI Registry.