Kaitlin Wickersham-Shafer, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71012651A Issued in IN

Practice address

1101 Michigan Ave
Logansport, IN 46947-1528

Phone

(574) 753-7541

NPI assigned

Jun 16, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kaitlin Trivedi Former name

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

Specialty

Nurse Practitioner

Education

University of Cincinnati College of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial HospitalGroup PAC ID 8123923281, 64 clinicians

Parkview Logansport Hospital IncGroup PAC ID 8921500646, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital Hospital, Logansport, IN, CCN 150072

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Parkview Logansport Hospital, Inc.

  • General Acute Care Hospital
  • Logansport, IN
  • NPI 1942317656
  Medicare reassignment Care Compare group NPD
• Parkview Logansport Hospital, Inc.

  • Rural Health Clinic/Center
  • Peru, IN
  • NPI 1770248015
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Parkview Logansport Hospital Inc

  • General Acute Care Hospital
  • Logansport, IN
  • NPI 1356320469
  Care Compare affiliation

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

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1831829233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471528",
            "telephone_number": "574-753-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKERSHAM-SHAFER",
        "first_name": "KAITLIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-16",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71012651A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "TRIVEDI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Roberta H Weinstein, PTA
• Todd Steven Weinstein, MD
• Alainna Wen, MA
• Angel White, RN
• Brandon L Whitehead, RDN
• Amanda M. Wickett, PSYD, H.S.P.P.
• Kathy Wierzchowski, MS
• Rebeccah A Wiley, BS
• Gabriella Williams
• Stacy Lynn Williams, MBA

• Nurse Practitioner in Logansport, IN
• Providers in Logansport, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.

Verify at the official NPI Registry.