Katherine Marie Shine, MSN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2004018456 Issued in MO

Practice address

621 S New Ballas Rd Ste 5003B
Saint Louis, MO 63141

Phone

(314) 251-8892

Fax

(314) 251-8894

NPI assigned

Aug 29, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kshine98583@directc.mercy.net

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.

• Mercy Clinic Child Neurology, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Saint Louis, MO
  • NPI 1285930206
  Medicare reassignment NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1194765685
  NPD (past)

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

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1427482157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 5003B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418270",
            "telephone_number": "314-251-8892",
            "fax_number": "314-251-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 5003B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-251-8892",
            "fax_number": "314-251-8894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 Frank Scott Pkwy W Ste 914",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622235000",
            "country_code": "US",
            "telephone_number": "618-277-1413",
            "fax_number": "618-277-1415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHINE",
        "first_name": "KATHERINE",
        "middle_name": "MARIE",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-29",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2004018456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorian G Shimotani, DO
• Nicole Jimin Shin, MD
• Stephanie Shin, DO
• Marwan Suleman Shinawi, MD
• Shine the Light Home Health Care, LLC
• Shines With Love LLC Consumer Direct Services
• Anna Michelle Shinneman, CNP
• Shinystars Homecare LLC
• Charles Michael Shipley, DO
• Gracie Shipley

• Family Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.