Shampayne Fentress-Clark

Primary specialty

Chore ProviderTaxonomy code 372500000X

License

25006459 Issued in NE

Practice address

4932 California St
Omaha, NE 68132-2418

Phone

(402) 830-1088

NPI assigned

Apr 8, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1659165272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 MEREDITH AVE UNIT 111024",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681112446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4932 CALIFORNIA ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681322418",
            "telephone_number": "402-830-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTRESS-CLARK",
        "first_name": "SHAMPAYNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "NE",
            "license": "25006459",
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "NE",
            "license": "25006459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Ann Fennell, CRNA
• Mary Madeline Fennessy
• Brigid Ann Fenoglio, MS CCC SLP
• Kari Lyn Fenton, LIMHP
• Larissa Fentress-Carter
• Ana Fentress
• Brandon Fentress
• Troy Fentress
• Christopher Fenwick
• Jack Ferbrache

• Chore Provider in Omaha, NE
• Providers in Omaha, NE by specialty
• Chore Provider in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; 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.