Individual provider Active NPI

Megan C Shanley, MSN, NP-C

  • Family Nurse Practitioner
  • Lafayette, IN
National Provider Identifier
1740645860
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28191307A Issued in IN
Practice address
1716 Hartford St
Lafayette, IN 47904-2173
Phone
(765) 742-1567
Fax
(765) 429-2763
NPI assigned
Dec 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 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 28191307A IN Primary

Addresses

Primary practice location

1716 Hartford St
Lafayette, IN 47904-2173

Mailing address

1716 Hartford St
Lafayette, IN 47904-2138
Phone (765) 742-1567

Other practice location 1

2316 South St
Lafayette, IN 47904-2971
Phone (765) 742-1567

Other identifiers 1

IdentifierTypeStateIssuer
201338870MedicaidIN

Other names 1

  • Megan C Erickson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20160119000233 IN Practitioner - Nurse Practitioner 4183927650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riggs Community Health Center IncGroup PAC ID 2365432226, 23 clinicians

Practice addresses (Care Compare)

1716 Hartford St
Lafayette, IN 47904-2173
Phone 76574215673041

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28191307AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riggs Community Health Center Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1450224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1740645860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 HARTFORD ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042138",
            "telephone_number": "765-742-1567",
            "fax_number": "765-429-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 HARTFORD ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042173",
            "telephone_number": "765-742-1567",
            "fax_number": "765-429-2763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2316 South St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479042971",
            "country_code": "US",
            "telephone_number": "765-742-1567",
            "fax_number": "765-429-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANLEY",
        "first_name": "MEGAN",
        "middle_name": "C",
        "credential": "MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-16",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28191307A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201338870",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "ERICKSON",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.