NPIMap

Individual provider Active NPI

Shannon Renae Wright, FNP

  • Family Nurse Practitioner
  • Belle, MO
National Provider Identifier
1619033404
Registry record updated Sep 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
155084 Issued in MO
Practice address
100 Highway 28 W
Belle, MO 65013-3405
Phone
(573) 859-3775
Fax
(573) 859-3997
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 155084 MO Primary

Addresses

Primary practice location

100 Highway 28 W
Belle, MO 65013-3405

Mailing address

PO Box 1027
Jefferson City, MO 65102-1027
Phone (573) 761-7246

Other identifiers 1

IdentifierTypeStateIssuer
1619033404MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20070523000456 MO Practitioner - Nurse Practitioner 2668579871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Regional Health ServicesGroup PAC ID 8921917352, 165 clinicians

Practice addresses (Care Compare)

100 Hwy 28 E
SSM Family Practice
Belle, MO 65013-3405
Phone (573) 859-3775

Hospital & facility affiliations

  • Central Missouri Home Health Home health agency, Jefferson City, MO, CCN 267448
  • SSM Health St. Mary'S Hospital - Jefferson City Hospital, Jefferson City, MO, CCN 260011
  • Phelps County Regional Medical Center Hospital, Rolla, MO, CCN 260017
  • University of Missouri Health Care Hospital, Columbia, MO, CCN 260141

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as group
Quality
86.39
Promoting interoperability
100
Improvement activities
40
Cost
73.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
155084MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Regional Health Services CurrentSince May 1, 2007 Accepting new patients
SSM Regional Health Services CurrentSince May 1, 2007 Accepting new patients
SSM Regional Health Services Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

7655 Solutions Ctr
Chicago, IL 60677

100 Highway 28 E
Belle, MO 65013
Phone (573) 859-3775

2511 W Edgewood Dr
Ste D
Jefferson City, MO 65109
Phone (573) 761-0304

100 Saint Marys Plz
Jefferson Cty, MO 65101
Phone (573) 635-7642

2265 Bagnell Dam Blvd
Lake Ozark, MO 65049
Phone (573) 365-6800

Interoperability endpoints

  • Direct secure messaging: swright63289@direct-ehr-ssmhc.com

Organizations & group practices 4

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 7

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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348790400000",
    "number": "1619033404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1027",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651021027",
            "telephone_number": "573-761-7246",
            "fax_number": "573-761-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGHWAY 28 W",
            "city": "BELLE",
            "state": "MO",
            "postal_code": "650133405",
            "telephone_number": "573-859-3775",
            "fax_number": "573-859-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "SHANNON",
        "middle_name": "RENAE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2012-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "155084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619033404",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belle, MO

Sources for this page

Verify at the official NPI Registry.