Shataura Anderson
Individual provider Active NPI Peer Specialist · Independence, MO
NPI 1720977952 · NPPES record last updated Jul 1, 2025
Key facts
- NPI
- 1720977952
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 12300 E US Highway 40 Ste a
Independence, MO 64055-6008 - Phone
- (725) 335-5159
- NPI assigned
- Jul 1, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| My Mental Health Is Kicking in LLC | Current |
Accepting new patients |
Locations
12300 E US Highway 40
Ste A
Independence, MO 64055
Phone (725) 335-5159
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Yes |
Addresses
Primary practice location
12300 E US Highway 40 Ste a
Independence, MO 64055-6008
Mailing address
12300 E US Highway 40 Ste a
Independence, MO 64055-6008
Phone (725) 335-5159
Other providers in Independence, MO
- Connie Elaine Anderson
- Farrah L Anderson
- Gloria Thomas Anderson
- Jennifer L Anderson
- Lane Thomas Anderson
- Thomas L Anderson
- Tyler Anderson
- Elizabeth A Andes
- Anesthesia Associates of Kansas City PC
- Karen Anghel
All providers in Independence, MO · Peer Specialist 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 1, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.