Individual provider Active NPI

Shana Christine Roether, FNP-BC

  • Family Nurse Practitioner
  • Milford, KS
National Provider Identifier
1912518481
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-79591-032 Issued in KS
Practice address
103 Smith St
Milford, KS 66514-5049
Phone
(785) 463-3333
Fax
(785) 463-3343
NPI assigned
Aug 10, 2020
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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 53-79591-032 KS Primary

Addresses

Primary practice location

103 Smith St
Milford, KS 66514-5049

Mailing address

103 Smith Street
PO Box 186
Milford, KS 66514-4030
Phone (785) 761-5725

Other practice location 1

361 Grant Ave
Junction City, KS 66441-4201
Phone (785) 238-4711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20210420001360 KS Practitioner - Nurse Practitioner 1658789227 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

103 Smith St
Milford, KS 66514-5049
Phone (785) 463-3333

361 Grant Ave
Junction City, KS 66441-4201
Phone (785) 238-4711

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-79591-032KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Konza Prairie Community Health Center, Inc. CurrentSince Jun 9, 2025 Accepting new patients
Konza Prairie Community Health Center, Inc. CurrentSince Jun 9, 2025 Accepting new patients
Konza Prairie Community Health Center, Inc. Past Accepting new patients

Locations

361 Grant Ave
Junction City, KS 66441
Phone (785) 238-4711

222 N 6th St
Ste 100
Manhattan, KS 66502
Phone (785) 320-7134

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JAFCAD
  • Direct secure messaging: shana.roether.1@24489.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1912518481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SMITH STREET",
            "address_2": "PO BOX 186",
            "city": "MILFORD",
            "state": "KS",
            "postal_code": "665144030",
            "telephone_number": "785-761-5725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SMITH ST",
            "city": "MILFORD",
            "state": "KS",
            "postal_code": "665145049",
            "telephone_number": "785-463-3333",
            "fax_number": "785-463-3343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "361 Grant Ave",
            "address_purpose": "LOCATION",
            "city": "Junction City",
            "state": "KS",
            "postal_code": "664414201",
            "country_code": "US",
            "telephone_number": "785-238-4711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROETHER",
        "first_name": "SHANA",
        "middle_name": "CHRISTINE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-79591-032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, KS

Sources for this page

Verify at the official NPI Registry.