NPIMap

Individual provider Active NPI

Shi Luo, DO

  • Hospitalist Physician
  • Burlington, WI
National Provider Identifier
1558010561
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
82152-21 Issued in WI
Practice address
252 McHenry St
Burlington, WI 53105-1828
Phone
(262) 767-6000
NPI assigned
Mar 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-18973 AR
Hospitalist Physician 208M00000X 82152-21 WI Primary

Addresses

Primary practice location

252 McHenry St
Burlington, WI 53105-1828

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

225 E Washington Ave
Jonesboro, AR 72401-3111
Phone (870) 207-4100

Other identifiers 1

IdentifierTypeStateIssuer
100424468MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250610004136 AR Practitioner - Internal Medicine 5799295507 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
St Bernards Hospital Inc.Group PAC ID 0941105480, 187 clinicians
Five Rivers Medical Center IncGroup PAC ID 1456540194, 37 clinicians
St Bernard Community Hospital CorporationGroup PAC ID 7810897485, shared by 4 NPIs, 12 clinicians

Practice addresses (Care Compare)

225 E Washington Ave
St Bernards Medical Center
Jonesboro, AR 72401-3119
Phone (870) 972-4100

2801 Medical Ctr Dr
Pocahontas, AR 72455-9436
Phone (870) 892-6204

310 Falls Blvd S
Wynne, AR 72396-3013
Phone (870) 238-3300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Five Rivers Medical Center CurrentSince Sep 1, 2025 Accepting new patients
St Bernards Hospital Inc. CurrentSince Jul 19, 2025 Accepting new patients
Five Rivers Medical Center Inc. CurrentSince Sep 1, 2025 Accepting new patients

Locations

1201 Fleming Ave
Jonesboro, AR 72401
Phone (870) 932-0440

225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630

2801 Medical Center Dr
Pocahontas, AR 72455
Phone (870) 892-6000

310 Falls Blvd S
Wynne, AR 72396
Phone (870) 208-2151

Organizations & group practices 5

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 5

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": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1558010561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 MCHENRY ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051828",
            "telephone_number": "262-767-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 E Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "AR",
            "postal_code": "724013111",
            "country_code": "US",
            "telephone_number": "870-207-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUO",
        "first_name": "SHI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-18",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-18973",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "82152-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100424468",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WI

Sources for this page

Verify at the official NPI Registry.