Shandon Wells Anderson, APRN-C

Individual provider Active NPI Primary Care Nurse Practitioner · Paola, KS

NPI 1609349265 · NPPES record last updated Jan 22, 2019

Key facts

NPI
1609349265
Entity type
Individual (NPI type 1)
Primary specialty
Primary Care Nurse Practitioner 363LP2300X
License
78535 (KS)
Practice address
2100 Baptiste Dr
Paola, KS 66071-1314
Phone
(913) 294-2327
NPI assigned
Jan 7, 2019
Sex
Male
Sole proprietor
No

Organizations & group practices 8

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 1

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

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventhealth Ransom Memorial Inc (40 clinicians)

Practice addresses (Care Compare)

1301 S Main St
Adventhealth Medical Group
Ottawa, KS 66067-3537
Phone (785) 229-3367

Hospital & facility affiliations

  • Adventhealth Ottawa Hospital · Ottawa, KS · CCN 170014

Merit-based Incentive Payment System (MIPS)

Final score
75.72 of 100 (group)
Quality
57.99
Promoting interoperability
100
Improvement activities
40
Cost
61.07

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20190208000267 KS Practitioner - Nurse Practitioner 2163760695 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
TMP-157777KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adventhealth Ransom Memorial, Inc. Current
since Mar 10, 2020
Accepting new patients
Miami County Medical Center Inc. Current
since Feb 1, 2019
Accepting new patients
Miami County Medical Center Inc. Current
since Feb 1, 2019
Accepting new patients
Miami County Medical Center Inc Current Accepting new patients
Adventhealth Ransom Memorial, Inc. Current
since Mar 10, 2020
Accepting new patients

Locations

901 S Main St
Ottawa, KS 66067
Phone (785) 229-8888

1301 S Main St
Ottawa, KS 66067
Phone (785) 229-3367

2100 Baptiste Dr
Paola, KS 66071
Phone (913) 294-2327

22386 S Harrison St
Spring Hill, KS 66083
Phone (913) 592-0010

Interoperability endpoints

  • Direct secure messaging: sanderson661497@adventhealth.direct-ci.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X TMP-157777 KS
Primary Care Nurse Practitioner 363LP2300X 78535 KS Yes

Addresses

Primary practice location

2100 Baptiste Dr
Paola, KS 66071-1314

Mailing address

37540 Crescent Hill Rd
Osawatomie, KS 66064-5181
Phone (913) 369-5200

Other providers in Paola, KS

All providers in Paola, KS · Primary Care Nurse Practitioner in Kansas

Sources for this page

Verify at the official NPI Registry.