Shanek F Vaccianna-Noe, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2025005026 Issued in MO

Practice address

965 Mattox Dr
Sullivan, MO 63080-2365

Phone

(573) 860-6000

NPI assigned

Feb 24, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Missouri Baptist Hospital of SullivanGroup PAC ID 2668380148, shared by 8 NPIs, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Missouri Baptist Hospital of Sullivan

  • Critical Access Hospital
  • Sullivan, MO
  • NPI 1295743169
  Medicare reassignment NPD
• Missouri Baptist Hospital of Sullivan

  • Rural Health Clinic/Center
  • Cuba, MO
  • NPI 1396827408
  Medicare reassignment NPD
• Missouri Baptist Hospital of Sullivan

  • Rural Health Clinic/Center
  • Sullivan, MO
  • NPI 1235228222
  NPD
• Missouri Baptist Hospital of Sullivan

  • Ambulance
  • Sullivan, MO
  • NPI 1831343268
  NPD

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1518763960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959318",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631959318",
            "telephone_number": "573-860-6000",
            "fax_number": "573-860-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 MATTOX DR",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630802365",
            "telephone_number": "573-860-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCIANNA-NOE",
        "first_name": "SHANEK",
        "middle_name": "F",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2025005026",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2025005026",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "965 Mattox Dr",
            "city": "Sullivan",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630802365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew J Tiefenbrunn, M.D.
• Sharon A Titter, MPT
• Amy E Torres, AGACNP-BC
• Megan S Turnbough, FNP
• United Seating and Mobility LLC
• Victorian Manor of Sullivan
• Vo Medical Clinic, P.C.
• Thanh Duy Vo, MD
• Tiffany J Voss, FNP
• David J Waddell, MD

• Nurse Practitioner in Sullivan, MO
• Providers in Sullivan, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.