Shannon Payne – Personal Care Attendant

Key facts

NPI: 1619794765
Entity type: Individual (NPI type 1)
Primary specialty: Personal Care Attendant 3747P1801X
Practice address: 503 School St
Bertrand, NE 68927-1206
Phone: (308) 472-3427
Fax: (308) 472-3429
NPI assigned: Sep 20, 2024
Sex: Female
Sole proprietor: No

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 and National Provider Directory roles.

Bertrand Community School Local Education Agency (LEA) · Bertrand, NE · NPI 1952031890

NPD

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Bertrand Community School		Current since Sep 23, 2024	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Personal Care Attendant	3747P1801X			Yes

Addresses

Primary practice location

503 School St
Bertrand, NE 68927-1206

Mailing address

503 School St
Bertrand, NE 68927-1206
Phone (308) 472-3427

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 20, 2024.

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1619794765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 SCHOOL ST",
            "city": "BERTRAND",
            "state": "NE",
            "postal_code": "689271206",
            "telephone_number": "308-472-3427",
            "fax_number": "308-472-3429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 SCHOOL ST",
            "city": "BERTRAND",
            "state": "NE",
            "postal_code": "689271206",
            "telephone_number": "308-472-3427",
            "fax_number": "308-472-3429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bertrand, NE

All providers in Bertrand, NE · Personal Care Attendant in Nebraska

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.