Shauntrece C Deters, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71003416A Issued in IN

Practice address

520 Mary St Ste 340
Evansville, IN 47710

Phone

(812) 450-3201

Fax

(812) 450-3395

NPI assigned

Oct 14, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082

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.

• Deaconess Clinic Inc.

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1619123585

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Deaconess Hospital, Inc

  • Hospitalist Physician
  • Evansville, IN
  • NPI 1427097443

  Nurse Practitioner

  Medicare reassignment NPD
• Jeffrey W. Selby MD PSC

  • Pulmonary Disease Physician
  • Newburgh, IN
  • NPI 1114056710
  Medicare reassignment NPD
• Deaconess Clinic Inc

  • Pediatrics Physician
  • Washington, IN
  • NPI 1356132310

  Nurse Practitioner

  NPD
• Deaconess Clinic, Inc

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1205082583

  Nurse Practitioner

  NPD
• Deaconess Hospital Inc

  • Mental Health Counselor
  • Evansville, IN
  • NPI 1508723552

  Nurse Practitioner

  NPD
• Selcare LLC

  • Primary Care Clinic/Center
  • Evansville, IN
  • NPI 1801171004
  NPD (past)

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

• Deaconess Hospital Inc

  • General Acute Care Hospital
  • Newburgh, IN
  • NPI 1780535427
  Care Compare affiliation
• Deaconess Hospital, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1053361642
  Care Compare affiliation

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1972813780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-450-3201",
            "fax_number": "812-450-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MARY ST STE 340",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47710",
            "telephone_number": "812-450-3201",
            "fax_number": "812-450-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETERS",
        "first_name": "SHAUNTRECE",
        "middle_name": "C",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-14",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003416A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71003416A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201059290",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dermplus
• Michael E Deroche, M.D.
• Jason Robert Derrington
• Brandi L Desper, NP
• Stephenie D Dest, OT
• Lindy Sykes Deusner, LCSW
• Naveen Kumar Devabhaktuni, M.D.
• Developedstherapy, LLC
• Developmental Diagnostics, Inc.
• Laura M Devers, CST, CSFA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; 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.