Active NPI
Shelby Lynn Icenhower, NP-C
- Family Nurse Practitioner
- Springfield, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2021031470
- Practice address
- 1235 E Cherokee St
Springfield, MO 65804-2203 - Phone
- (417) 820-2115
- NPI assigned
- Sep 1, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2021031470 | MO | Primary |
Addresses
Primary practice location
1235 E Cherokee St
Springfield, MO 65804-2203
Mailing address
1235 E Cherokee St
Springfield, MO 65804-2203
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Clinic Springfield Communities
Practice addresses (Care Compare)
100 Hospital Dr
Lebanon, MO 65536-9210
Phone (417) 553-6059
1235 E Cherokee St
Springfield, MO 65804-2203
Phone (417) 820-2600
Hospital & facility affiliations
- Mercy Hospital Springfield
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Citizens Memorial Hospital District | Current | Accepting new patients | |
| Mercy Hospital Springfield | Current | Accepting new patients | |
| Putnam Orthopaedic Center, LLC | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Hospital Springfield | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Family | Current | Accepting new patients |
| Citizens Memorial Hospital District | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Family | Current | Accepting new patients |
Locations
1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000
100 Hospital Dr
Lebanon, MO 65536
Phone (417) 533-6010
1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115
4350 S National Ave
Ste C200
Springfield, MO 65810
Phone (417) 447-1000
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.
-
- General Acute Care Hospital
- Springfield, MO
- NPI 1043242159
-
- Emergency Medicine Physician
- Bolivar, MO
- NPI 1558548818
-
- Family Medicine Physician
- Springfield, MO
- NPI 1245277631
-
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
Family
-
- Adult Reconstructive Orthopaedic Surgery Physician
- Springfield, MO
- NPI 1275677023
-
- Community/Retail Pharmacy
- Buffalo, MO
- NPI 1427480995
-
- Rural Health Clinic/Center
- Mountain View, MO
- NPI 1003946732
Family
-
- Medicare Defined Swing Bed Hospital Unit
- Springfield, MO
- NPI 1053907113
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Springfield, MO
- NPI 1578504056
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630454400000",
"number": "1619645918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1235 E CHEROKEE ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658042203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1235 E CHEROKEE ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658042203",
"telephone_number": "417-820-2115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ICENHOWER",
"first_name": "SHELBY",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-01",
"last_updated": "2021-09-01",
"certification_date": "2021-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "2021031470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.