Individual provider Active NPI

Shannon Deann Dobsch, FNP

  • Family Nurse Practitioner
  • Washington, MO
National Provider Identifier
1821634247
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F10191224 Issued in MO
Practice address
1063 Bieker Rd
Washington, MO 63090-6621
Phone
(636) 221-2486
NPI assigned
Nov 20, 2019
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 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 F10191224 MO Primary

Addresses

Primary practice location

1063 Bieker Rd
Washington, MO 63090-6621

Mailing address

PO Box 1092
Washington, MO 63090-8092
Phone (636) 221-2486

Other practice location 1

1111 W. Pearce Bouelvard
Wentzville, MO 63385-1020
Phone (636) 856-5362

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200211001752 MO Practitioner - Nurse Practitioner 5496181471 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital LincolnGroup PAC ID 5193040020, 31 clinicians
Mercy East Ambulatory Services LLCGroup PAC ID 2365739240, 102 clinicians
SSM Health Care St LouisGroup PAC ID 7810800737, 171 clinicians

Practice addresses (Care Compare)

1000 E Cherry St
Mercy Emergency Department
Troy, MO 63379-1513
Phone (636) 528-3221

1111 W Pearce Blvd
Wentzville, MO 63385-1020
Phone (636) 856-5363

1601 Wentzville Pkwy
130 SSM Health Urgent Care Wentzville
Wentzville, MO 63385-3923
Phone (636) 332-8475

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F10191224MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy East Ambulatory Services LLC CurrentSince Jan 21, 2024 Accepting new patients
Mercy Hospital Lincoln CurrentSince Dec 13, 2022 Accepting new patients
Emergency Physicians of St. Luke's, LLC CurrentSince Dec 20, 2022 Accepting new patients
SSM Health Care St Louis CurrentSince Dec 15, 2020 Accepting new patients
SSM Health Care St. Louis CurrentSince Dec 15, 2020 Accepting new patients
Cep America, LLC Current Accepting new patients
Cep America LLC CurrentSince Feb 1, 2020 Accepting new patients
Associated Physicians Group, LTD CurrentSince Mar 4, 2022 Accepting new patients
Cep America LLC CurrentSince Feb 1, 2020 Accepting new patients
Associated Physicians Group LTD Current Accepting new patients
Mercy Hospital Lincoln CurrentSince Dec 13, 2022 Accepting new patients
Physician Specialists of St Lukes LLC Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

916 Talon Dr
#102
O Fallon, IL 62269
Phone (618) 628-8211

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

233 Clarkson Rd
Ellisville, MO 63011
Phone (636) 256-8644

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

774 Gravois Bluffs Blvd
Fenton, MO 63026
Phone (636) 343-5223

409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

605 N Commercial Ave
Saint Clair, MO 63077
Phone (636) 629-2414

1145 Corporate Lake Dr
Saint Louis, MO 63132
Phone (314) 989-6189

845 N New Ballas Ct
Ste 120
Saint Louis, MO 63141
Phone (314) 200-0997

1000 E Cherry St
Troy, MO 63379
Phone (636) 528-3327

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777

1111 W Pearce Blvd
Wentzville, MO 63385
Phone (636) 856-5362

1601 Wentzville Pkwy
Ste 130
Wentzville, MO 63385
Phone (636) 332-8455

Interoperability endpoints

  • Direct secure messaging: sdobsch178810@direct-ehr-ssmhc.com

Organizations & group practices 12

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.

Hospital & facility affiliations 2

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": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1821634247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1092",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630908092",
            "telephone_number": "636-221-2486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1063 BIEKER RD",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630906621",
            "telephone_number": "636-221-2486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 W. Pearce Bouelvard",
            "address_purpose": "LOCATION",
            "city": "Wentzville",
            "state": "MO",
            "postal_code": "633851020",
            "country_code": "US",
            "telephone_number": "636-856-5362",
            "fax_number": "636-856-5363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOBSCH",
        "first_name": "SHANNON",
        "middle_name": "DEANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-20",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "F10191224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

Verify at the official NPI Registry.