Individual provider Active NPI

John M Shetlar, DO

  • Family Medicine Physician
  • Leavenworth, KS
National Provider Identifier
1821053091
Registry record updated Aug 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0524233 Issued in KS
Practice address
1100 N 4TH St
Leavenworth, KS 66048-1572
Phone
(888) 381-4858
Fax
(913) 297-9628
NPI assigned
Apr 19, 2006
Last updated
Aug 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0524233 KS Primary

Addresses

Primary practice location

1100 N 4TH St
Leavenworth, KS 66048-1572

Mailing address

1100 N 4TH St
Leavenworth, KS 66048-1572
Phone (888) 381-4858

Other practice location 1

2741 NE McBaine Dr
Lees Summit, MO 64064-7880
Phone (816) 554-2600

Other practice location 2

4140A Laramie St
Cheyenne, WY 82001-1969
Phone (307) 637-2800

Other practice location 3

4140 Laramie St
Cheyenne, WY 82001-1969
Phone (307) 637-2800

Other practice location 4

110 N 66th St
Lincoln, NE 68505-2402
Phone (402) 325-8950

Other practice location 5

202 E Nifong Blvd
Columbia, MO 65203-3759
Phone (573) 874-6825

Other practice location 6

7380 W 52nd Ave Unit 1
Arvada, CO 80002-3716
Phone (303) 463-5941

Other identifiers 1

IdentifierTypeStateIssuer
100162320EMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, CO, MO, NE, WY5 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20071130000326 KS Practitioner - Family PracticePractitioner - General Practice 2668561523 Reassigns benefits to 1 organization
I20230420001868 CO Practitioner - General Practice 2668561523 Reassigns benefits to 1 organization
I20230523000309 MO Practitioner - General Practice 2668561523 Reassigns benefits to 2 organizations
I20230918000443 NE Practitioner - General Practice 2668561523 Reassigns benefits to 2 organizations
I20250911003199 WY Practitioner - General Practice 2668561523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emergent Care Plus of Overland Park LLCGroup PAC ID 8123153939, 26 clinicians
Colorado Urgent Care PLLCGroup PAC ID 6002834645, 26 clinicians
Nextcare Missouri LLCGroup PAC ID 7517259252, 9 clinicians
Emergent Care Plus LLCGroup PAC ID 0547328460, 18 clinicians

Practice addresses (Care Compare)

1100 N 4TH St
Leavenworth, KS 66048-1572
Phone (913) 297-9945

18890 E Hampden Ave
Aurora, CO 80013-3504
Phone (303) 617-1604

202 E Nifong Blvd
Providence Urgent Care Nifong
Columbia, MO 65203-3759
Phone (573) 874-6824

2741 NE McBaine Dr
Lees Summit, MO 64064-7880
Phone (816) 554-2600

4590 W 121St Ave
Broomfield, CO 80020-5666
Phone (303) 439-4544

7380 W 52ND Ave
Unit I
Arvada, CO 80002-3719
Phone (303) 463-5941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2825NEMDMental Health Counselor
0524233KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wright Turn Lane PC Family Medicine CurrentSince Jul 25, 2023 Accepting new patients
Colorado Urgent Care PLLC Current Accepting new patients
Providence Urgent Care LLC CurrentSince Jul 29, 2009 Accepting new patients
Nextcare Missouri LLC CurrentSince Apr 20, 2023 Accepting new patients
Colorado Urgent Care PLLC CurrentSince Mar 23, 2023 Accepting new patients
Wright Turn Lane PC CurrentSince Jul 25, 2023 Accepting new patients
Emergent Care Plus, LLC Family Medicine CurrentSince Apr 20, 2023 Accepting new patients
Colorado Urgent Care PLLC CurrentSince Mar 23, 2023 Accepting new patients
College Drive Urgent Care LLC CurrentSince Aug 19, 2025 Accepting new patients
Emergent Care Plus of Overland Park, LLC Family Medicine CurrentSince Mar 24, 2022 Accepting new patients
Nextcare Nebraska Providers LLC CurrentSince Jul 25, 2023 Accepting new patients
Medi Horizons Inc Family Medicine Past Accepting new patients
Comcare, P.a. Past Accepting new patients

Locations

18890 E Hampden Ave
Aurora, CO 80013
Phone (303) 617-1604

1100 N 4th St
Leavenworth, KS 66048
Phone (913) 297-9945

2770 S 9th St
Salina, KS 67401
Phone (785) 827-3551

202 E Nifong Blvd
Columbia, MO 65203
Phone (573) 874-6824

10015 N Ambassador Dr
Ste 100
Kansas City, MO 64153
Phone (816) 595-4000

2741 NE McBaine Dr
Lees Summit, MO 64064
Phone (816) 554-2600

110 N 66th St
Lincoln, NE 68505
Phone (402) 325-8950

8419 S 73rd Plz
Ste 101
Papillion, NE 68046
Phone (402) 991-9060

309 S Lincoln Ave
York, NE 68467
Phone (402) 720-9986

627 N Lincoln Ave
York, NE 68467

2030 Bluegrass Cir
Cheyenne, WY 82009
Phone (307) 635-3500

4140 Laramie St
Cheyenne, WY 82001
Phone (307) 259-4655

4140 Laramie St
#A
Cheyenne, WY 82001
Phone (307) 637-2800

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755993600000",
    "number": "1821053091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N 4TH ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660481572",
            "telephone_number": "888-381-4858",
            "fax_number": "913-297-9628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N 4TH ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660481572",
            "telephone_number": "888-381-4858",
            "fax_number": "913-297-9628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2741 NE McBaine Dr",
            "address_purpose": "LOCATION",
            "city": "Lees Summit",
            "state": "MO",
            "postal_code": "640647880",
            "country_code": "US",
            "telephone_number": "816-554-2600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4140A Laramie St",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820011969",
            "country_code": "US",
            "telephone_number": "307-637-2800",
            "fax_number": "307-637-2867",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4140 Laramie St",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820011969",
            "country_code": "US",
            "telephone_number": "307-637-2800",
            "fax_number": "307-637-2867",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 N 66th St",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685052402",
            "country_code": "US",
            "telephone_number": "402-325-8950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "202 E Nifong Blvd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652033759",
            "country_code": "US",
            "telephone_number": "573-874-6825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7380 W 52nd Ave Unit 1",
            "address_purpose": "LOCATION",
            "city": "Arvada",
            "state": "CO",
            "postal_code": "800023716",
            "country_code": "US",
            "telephone_number": "303-463-5941",
            "fax_number": "303-463-5951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHETLAR",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2025-08-24",
        "certification_date": "2025-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0524233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100162320E",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leavenworth, KS

Sources for this page

Verify at the official NPI Registry.