Erin Ashley Shaefer, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209.028133 Issued in IL

Practice address

520 N 4TH St
Springfield, IL 62702-5238

Phone

(217) 545-8000

Fax

(217) 757-8161

NPI assigned

Aug 22, 2023

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 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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Killian and Associates SCGroup PAC ID 4082503610, 9 clinicians

Board of Trustees of Southern Illinois UniversityGroup PAC ID 4486667888, 139 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Medical Center Hospital, Springfield, IL, CCN 140148

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: erinshaefer@siusm.allscriptsdirect.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.

• Board of Trustees of Southern Illinois University

  • Primary Care Clinic/Center
  • Springfield, IL
  • NPI 1396097960
  Medicare reassignment Care Compare group NPD
• Killian and Associates SC

  • Psychiatry Physician
  • Springfield, IL
  • NPI 1487642708
  Medicare reassignment Care Compare group NPD
• Board of Trustees of Southern Illinois University

  • Rural Health Clinic/Center
  • Carbondale, IL
  • NPI 1215978127
  NPD
• Board of Trustees of Southern Illinois University

  • Federally Qualified Health Center (FQHC)
  • Carbondale, IL
  • NPI 1568210425
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Medical Center

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1255317590
  Care Compare affiliation

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1548044308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N 4TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025238",
            "telephone_number": "217-545-8000",
            "fax_number": "217-757-8161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "319 E Madison St Ste 1F",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627013118",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "fax_number": "217-757-8161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "710 N 8th St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627026324",
            "country_code": "US",
            "telephone_number": "217-525-1064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAEFER",
        "first_name": "ERIN",
        "middle_name": "ASHLEY",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.028133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor M Setzer, RBT
• William C. Severino, M.D.
• Claire Sexton
• Jennifer K Sexton
• Mary Louise Sexton, MA
• Kara A Shafer, DO
• Kayla M Shafer, PHYSICAL THERAPIST
• Brooke Shaffer
• John C. Shaffer, M.D.
• Lonndon Taylor Shaffer

• Psychiatric/Mental Health Nurse Practitioner in Springfield, IL
• Providers in Springfield, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.