Individual provider Active NPI

Shannon Scroggins

  • Nurse Practitioner
  • Sterling, IL
National Provider Identifier
1447657689
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
041388030 Issued in IL
Practice address
101 E Miller Rd
Sterling, IL 61081-1252
Phone
(815) 625-4790
NPI assigned
Dec 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 041388030 IL Primary

Addresses

Primary practice location

101 E Miller Rd
Sterling, IL 61081-1252

Mailing address

101 E Miller Rd
Sterling, IL 61081-1252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20150105000390 IL Practitioner - Nurse Practitioner 2668795329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CGH Medical CenterGroup PAC ID 6103723267, 199 clinicians

Practice addresses (Care Compare)

15 W 3Rd St
Sterling, IL 61081-3510
Phone (815) 625-0226

Hospital & facility affiliations

  • CGH Medical Center Hospital, Sterling, IL, CCN 140043

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041388030ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CGH Medical Center Current Accepting new patients
CGH Medical Center CurrentSince Dec 9, 2014 Accepting new patients
CGH Medical Center CurrentSince Dec 9, 2014 Accepting new patients

Locations

101 E Miller Rd
Sterling, IL 61081
Phone (815) 632-5285

15 W 3rd St
Sterling, IL 61081
Phone (815) 564-1999

Interoperability endpoints

  • Direct secure messaging: sscroggins21068@cghmc.direct-ci.com

Organizations & group practices 3

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": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417564800000",
    "number": "1447657689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MILLER RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MILLER RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811252",
            "telephone_number": "815-625-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCROGGINS",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-03",
        "last_updated": "2014-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "041388030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, IL

Sources for this page

Verify at the official NPI Registry.