Mary Ellen Shanks, APRN,BC,FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2010027851 Issued in MO

Practice address

504 N Sturgeon St
Montgomery City, MO 63361-1829

Phone

(573) 564-2990

Fax

(573) 564-2963

NPI assigned

Aug 26, 2010

Last updated

Oct 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/f62890b5-77ff-44bd-a981-0a0981047b35/

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Montgomery County Health Department

  • Home Health Agency
  • Montgomery City, MO
  • NPI 1902892375

  Corporate Officer

  CMS ownership

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.

• Hermann Area Hospital District

  dba Hermann Area District Hospital

  • Family Medicine Physician
  • Hermann, MO
  • NPI 1083749188
  Medicare reassignment NPD
• Hermann Area Hospital District

  dba Hermann Area District Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Hermann, MO
  • NPI 1679648661
  NPD
• Montgomery County Health Department

  • Home Health Agency
  • Montgomery City, MO
  • NPI 1902892375
  NPD

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1710293972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19",
            "city": "MONTGOMERY CITY",
            "state": "MO",
            "postal_code": "633610019",
            "telephone_number": "573-564-2990",
            "fax_number": "573-564-2963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N STURGEON ST",
            "city": "MONTGOMERY CITY",
            "state": "MO",
            "postal_code": "633611829",
            "telephone_number": "573-564-2990",
            "fax_number": "573-564-2963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKS",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "APRN,BC,FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2010027851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mshanks@hadh.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Associated Medical Arts Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "504 N Sturgeon St",
            "city": "Montgomery City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633611829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Raymond H. Wilbers, Inc (Wilbers Family Care Clinic)
• Robert M. Palmer, O.D., P.C.
• Michael Thomas Rothermich, M.D.
• Ashley Irene Schreiner, PHARMD
• Patricia T. Schroff, SPEECH-LANGUAGE PATH
• Londa Y Swoboda, FNP, BSN, MSN
• The Healthy Choice LLC
• Holly Thomas, PMHNP
• Tawni Willis, M.A., CCC/SLP
• Deanna Winingear, PHARM.D.

• Family Nurse Practitioner in Montgomery City, MO
• Providers in Montgomery City, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.