Shelly Ann Shannon, LPN

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Practice address

1115 Elm St
Saint Paul, NE 68873-1907

Phone

(402) 680-5563

Fax

(308) 754-7876

NPI assigned

Mar 24, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Gentle Hands Home Care LLC Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1629655048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 ELM ST",
            "city": "SAINT PAUL",
            "state": "NE",
            "postal_code": "688731907",
            "telephone_number": "402-680-5563",
            "fax_number": "308-754-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 ELM ST",
            "city": "SAINT PAUL",
            "state": "NE",
            "postal_code": "688731907",
            "telephone_number": "402-680-5563",
            "fax_number": "308-754-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "SHELLY",
        "middle_name": "ANN",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENTLE HANDS HOME",
            "last_name": "LLC",
            "middle_name": "CARE",
            "credential": "IN HOME CARE SERVICE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Tamara Ross
• Madison Rother
• Bradley M Schoch, DDS
• Kelly Jean Simeon, PTA
• Debra Smith
• St Paul Public School
• St. Paul Early Childhood Foundation (Kid Academy)
• Heidi Sue Stelk, LPN

• In Home Supportive Care Agency in Saint Paul, NE
• Providers in Saint Paul, NE by specialty
• In Home Supportive Care Agency in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.