Shelby Paige Bollinger, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Sikeston, MO
NPI 1659941219 · NPPES record last updated Jul 20, 2023
Key facts
- NPI
- 1659941219
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 2021024541 (MO)
- Practice address
- 760 Plantation Blvd
Sikeston, MO 63801-5736 - Phone
- (573) 471-0800
- Fax
- (573) 471-0810
- NPI assigned
- Jun 28, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bootheel Counseling Services
Practice addresses (Care Compare)
760 Plantation Blvd
Sikeston, MO 63801-5736
Phone (573) 471-0800
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211008000350 | MO | Practitioner - Nurse Practitioner | 5597163378 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021024541 | MO | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bootheel Counseling Services | Current |
Accepting new patients | |
| Bootheel Counseling Services | Current |
Accepting new patients | |
| Bootheel Counseling Services | Past |
Accepting new patients |
Locations
760 Plantation Blvd
Sikeston, MO 63801
Phone 5734710880245
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 2021024541 | MO | Yes |
Addresses
Primary practice location
760 Plantation Blvd
Sikeston, MO 63801-5736
Mailing address
760 Plantation Blvd
Sikeston, MO 63801-5736
Phone (573) 471-0800
Other providers in Sikeston, MO
- Kevin J. Blanton
- Leisa Y Blissett
- Kathryn Ann Bohannon
- Andrew B. Boldrey
- Sandra T Bollinger
- Valerie Lynne Bollinger
- Andrea Kaye Bone
- Donna Jean Boone-Springer
- Bootheel Counseling Services
- Bootheel Counseling Services
All providers in Sikeston, MO · Psychiatric/Mental Health Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.