Active NPI
Shelby Leppin, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Kirksville, MO
National Provider Identifier
1801381876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 2018021492
- Practice address
- 900 E Laharpe St
Kirksville, MO 63501-4520 - Phone
- (660) 292-4895
- NPI assigned
- Jun 22, 2018
- Last updated
- Apr 25, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 2018021492 | MO | Primary |
Addresses
Primary practice location
900 E Laharpe St
Kirksville, MO 63501-4520
Mailing address
PO Box 34
Kirksville, MO 63501-0034
Phone (660) 626-0640
Other names 1
- Shelby Tracy
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
154 Forrest Dr
Hannibal, MO 63401-5511
Phone (573) 221-2120
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018021492 | MO | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark Twain Association for Mental Health, Inc | Current | Accepting new patients | |
| Mark Twain Association for Mental Health, Inc. | Current | Accepting new patients | |
| Preferred Family Healthcare | Past | Accepting new patients |
Locations
154 Forrest Dr
Hannibal, MO 63401
Phone (573) 221-2120
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 3
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.
-
dba Mark Twain Behavioral Health
- Community/Behavioral Health Agency
- Hannibal, MO
- NPI 1700933363
-
dba Mark Twain Behavioral Health
- Community/Behavioral Health Agency
- Hannibal, MO
- NPI 1104368703
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Macon, MO
- NPI 1134252034
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556150400000",
"number": "1801381876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34",
"city": "KIRKSVILLE",
"state": "MO",
"postal_code": "635010034",
"telephone_number": "660-626-0640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 E LAHARPE ST",
"city": "KIRKSVILLE",
"state": "MO",
"postal_code": "635014520",
"telephone_number": "660-292-4895"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEPPIN",
"first_name": "SHELBY",
"credential": "PMHNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-22",
"last_updated": "2019-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MO",
"license": "2018021492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHELBY",
"last_name": "TRACY",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Kirksville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.