Individual provider Active NPI

Mackenzie Jean Shawgo, APRN, WHNP-BC

  • Women's Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1619889565
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
2026045463 Issued in MO
Practice address
555 N New Ballas Rd Ste 150
Saint Louis, MO 63141-6843
Phone
(314) 983-9000
NPI assigned
Sep 17, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 2026045463 MO Primary

Addresses

Primary practice location

555 N New Ballas Rd Ste 150
Saint Louis, MO 63141-6843

Mailing address

2041 Yale Ave Apt a
Saint Louis, MO 63143-1469
Phone (616) 218-2955

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1789603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1619889565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 YALE AVE APT A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631431469",
            "telephone_number": "616-218-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N NEW BALLAS RD STE 150",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416843",
            "telephone_number": "314-983-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAWGO",
        "first_name": "MACKENZIE",
        "middle_name": "JEAN",
        "credential": "APRN, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-17",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MO",
            "license": "2026045463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.