NPIMap

Individual provider Active NPI

Shawn C Brown, F.N.P.

  • Family Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1629065073
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
106676 Issued in MO
Practice address
2711 S Meadowbrook Ave
Springfield, MO 65807-5924
Phone
(417) 887-0081
NPI assigned
Sep 30, 2005
Last updated
Dec 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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 106676 MO Primary

Addresses

Primary practice location

2711 S Meadowbrook Ave
Springfield, MO 65807-5924

Mailing address

2711 S Meadowbrook Ave
Springfield, MO 65807-5924
Phone (417) 887-0081

Other identifiers 2

IdentifierTypeStateIssuer
P01038081OtherMORR CARE
1629065073MedicaidMO

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
I20071031000505 MO Practitioner - Nurse Practitioner 1759478290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

2711 S Meadowbrook Ave
MC Family Medicine South Creek
Springfield, MO 65807-5924
Phone (417) 887-0081

448 State Hwy 248
Suite 150
Branson, MO 65616-3725
Phone (417) 336-6713

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Jan 13, 2020 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jan 13, 2020 Accepting new patients
Mercy Clinic Springfield Communities Family CurrentSince Jan 13, 2020 Accepting new patients
Wellpointe Family Medical Past Accepting new patients

Locations

448 State Highway 248
Ste 150
Branson, MO 65616
Phone (417) 336-6713

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

1718 W Woodland St
Springfield, MO 65807
Phone (417) 887-0081

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

2711 S Meadowbrook Ave
Springfield, MO 65807
Phone (417) 887-0081

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

Interoperability endpoints

  • Direct secure messaging: sbrown1044437@directc.mercy.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1629065073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 S MEADOWBROOK AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075924",
            "telephone_number": "417-887-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 S MEADOWBROOK AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075924",
            "telephone_number": "417-887-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SHAWN",
        "middle_name": "C",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "106676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR CARE",
            "identifier": "P01038081",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629065073",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.