Individual provider Active NPI

Sandy Shannon, PRACTICAL NURSE, CNA

  • In Home Supportive Care Agency
  • Saint Louis, MO
National Provider Identifier
1871406439
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Practice address
3636 Page Blvd
Unit a
Saint Louis, MO 63113
Phone
(314) 328-1112
NPI assigned
Sep 24, 2026
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X MO Primary

Addresses

Primary practice location

3636 Page Blvd
Unit a
Saint Louis, MO 63113

Mailing address

3636 Page Blvd
Unit a
Saint Louis, MO 63113
Phone (314) 328-1112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1871406439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 PAGE BLVD",
            "address_2": "UNIT A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63113",
            "telephone_number": "314-328-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 PAGE BLVD",
            "address_2": "UNIT A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63113",
            "telephone_number": "314-328-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "SANDY",
        "credential": "PRACTICAL NURSE, CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-24",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.