NPIMap

Individual provider Active NPI

Shawn Eric Raymond, APRN

  • Family Nurse Practitioner
  • Neodesha, KS
National Provider Identifier
1639501208
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-76041-081 Issued in KS
Practice address
2600 Ottawa Rd
Neodesha, KS 66757-1897
Phone
(620) 325-2611
NPI assigned
Aug 6, 2013
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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 53-76041-081 KS Primary

Addresses

Primary practice location

2600 Ottawa Rd
Neodesha, KS 66757-1897

Mailing address

PO Box 360
Neodesha, KS 66757-0360
Phone (620) 325-2611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20131109000202 KS Practitioner - Nurse Practitioner 1355576828 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenwood County HospitalGroup PAC ID 0042129603, 31 clinicians

Practice addresses (Care Compare)

100 W 16TH St
Eureka, KS 67045-1064
Phone (620) 583-5274

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-76041-081KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greenwood County Hospital CurrentSince Jan 4, 2014 Accepting new patients
Wilson County Hospital CurrentSince Nov 23, 2013 Accepting new patients
Wilson County Hospital Current Accepting new patients
Greenwood County Hospital CurrentSince Jan 4, 2014 Accepting new patients
Wilson County Hospital Current Accepting new patients
Wilson County Hospital CurrentSince Nov 23, 2013 Accepting new patients
Greenwood County Hospital Past Accepting new patients

Locations

100 W 16th St
Eureka, KS 67045
Phone (620) 583-5274

209 N 6th St
Ste 103
Independence, KS 67301
Phone (620) 331-2400

2600 Ottawa Rd
Neodesha, KS 66757
Phone (620) 325-2611

Interoperability endpoints

  • Direct secure messaging: shawn.raymond.1@12044.direct.athenahealth.com
  • Direct secure messaging: shawn.raymond@khindirect.org

Organizations & group practices 7

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 6

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": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1639501208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360",
            "city": "NEODESHA",
            "state": "KS",
            "postal_code": "667570360",
            "telephone_number": "620-325-2611",
            "fax_number": "620-325-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 OTTAWA RD",
            "city": "NEODESHA",
            "state": "KS",
            "postal_code": "667571897",
            "telephone_number": "620-325-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "SHAWN",
        "middle_name": "ERIC",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-06",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-76041-081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neodesha, KS

Sources for this page

Verify at the official NPI Registry.