Individual provider Active NPI

Shannon M Jeffrey, MSN, ARNP

  • Nurse Practitioner
  • Junction City, KS
National Provider Identifier
1598752743
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
MJ1111880 Issued in KS
Practice address
361 Grant Ave
Junction City, KS 66441-4201
Phone
(785) 238-4711
Fax
(785) 238-4260
NPI assigned
Oct 3, 2005
Last updated
Nov 13, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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 MJ1111880 KS Primary

Addresses

Primary practice location

361 Grant Ave
Junction City, KS 66441-4201

Mailing address

PO Box 1107
Junction City, KS 66441-1107
Phone (785) 238-4711

Other identifiers 3

IdentifierTypeStateIssuer
JEFFREYOtherKSWPPA
161261OtherKSBLUE CROSS BLUE SHIELD
0000161261OtherKSTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
MJ1111880KSMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1598752743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1107",
            "city": "JUNCTION CITY",
            "state": "KS",
            "postal_code": "664411107",
            "telephone_number": "785-238-4711",
            "fax_number": "785-238-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 GRANT AVE",
            "city": "JUNCTION CITY",
            "state": "KS",
            "postal_code": "664414201",
            "telephone_number": "785-238-4711",
            "fax_number": "785-238-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFREY",
        "first_name": "SHANNON",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "MSN, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-03",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "MJ1111880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPPA",
            "identifier": "JEFFREY",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "161261",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "0000161261",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Junction City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.