Individual provider Active NPI

Shirley Dawn Metker, ARNP

  • Nurse Practitioner
  • Stanford, KY
National Provider Identifier
1619012937
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2064P Issued in KY
Practice address
44 Health Way
Stanford, KY 40484
Phone
(606) 365-3106
Fax
(606) 365-1640
NPI assigned
Feb 21, 2007
Last updated
Apr 23, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2064P KY Primary
Registered Nurse 163W00000X 1071665 KY

Addresses

Primary practice location

44 Health Way
Stanford, KY 40484

Mailing address

104 Kidsfort Trail
Stanford, KY 40484
Phone (606) 365-3102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1071665KYMDRegistered Nurse
2064PKYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln County Health Department Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1619012937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 KIDSFORT TRAIL",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "40484",
            "telephone_number": "606-365-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 HEALTH WAY",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "40484",
            "telephone_number": "606-365-3106",
            "fax_number": "606-365-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METKER",
        "first_name": "SHIRLEY",
        "middle_name": "DAWN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "2064P",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1071665",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, KY

Sources for this page

Verify at the official NPI Registry.