Individual provider Active NPI

Shianne Marie Farris, DO

  • Family Medicine Physician
  • Sedalia, MO
National Provider Identifier
1508536111
Registry record updated Jun 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2023023526 Issued in MO
Practice address
3401 W 10TH St
Sedalia, MO 65301-2112
Phone
(660) 827-2883
NPI assigned
Sep 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2023023526 MO Primary

Addresses

Primary practice location

3401 W 10TH St
Sedalia, MO 65301-2112

Mailing address

3401 W 10TH St
Sedalia, MO 65301-2112
Phone (660) 827-2883

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250430002818 MO Practitioner - Family Practice 4688032782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bothwell Regional Health CenterGroup PAC ID 6103714126, 109 clinicians

Practice addresses (Care Compare)

2925 Clinton Rd
Sedalia, MO 65301-7915
Phone (660) 829-5852

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Bothwell Regional Health Center Family Medicine CurrentSince Apr 1, 2025 Accepting new patients
Bothwell Regional Health Center Current Accepting new patients
Bothwell Regional Health Center CurrentSince Apr 1, 2025 Accepting new patients

Locations

3401 W 10th St
Sedalia, MO 65301
Phone (660) 827-0015

2925 Clinton Rd
Sedalia, MO 65301
Phone (660) 829-5852

601 E 14th St
Sedalia, MO 65301
Phone (660) 826-8833

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 2

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": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686960000000",
    "number": "1508536111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 W 10TH ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012112",
            "telephone_number": "660-827-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 W 10TH ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012112",
            "telephone_number": "660-827-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRIS",
        "first_name": "SHIANNE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2023-06-17",
        "certification_date": "2023-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2023023526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedalia, MO

Sources for this page

Verify at the official NPI Registry.