Individual provider Active NPI

Terry Shaffer, R.N.

  • Community Health Registered Nurse
  • Robinson, IL
National Provider Identifier
1629332945
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
041253523 Issued in IL
Practice address
202 N Bline Blvd
Robinson, IL 62454-1264
Phone
(618) 544-8798
Fax
(618) 544-9398
NPI assigned
Jul 2, 2012
Last updated
Jul 2, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 041253523 IL Primary

Addresses

Primary practice location

202 N Bline Blvd
Robinson, IL 62454-1264

Mailing address

RR 2 Box 224B
Lawrenceville, IL 62439-9644
Phone (618) 928-2135

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041253523ILMDCommunity Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Board Members-Crawford County Government Past Accepting new patients
Crawford County Health Department Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1629332945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 224B",
            "city": "LAWRENCEVILLE",
            "state": "IL",
            "postal_code": "624399644",
            "telephone_number": "618-928-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N BLINE BLVD",
            "city": "ROBINSON",
            "state": "IL",
            "postal_code": "624541264",
            "telephone_number": "618-544-8798",
            "fax_number": "618-544-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "TERRY",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "IL",
            "license": "041253523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robinson, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; 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.