Kimberly B Shelanskey, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209008580 Issued in IL

Practice address

200 Riverside Dr
Bourbonnais, IL 60914-4689

Phone

(815) 933-9660

Fax

(815) 929-0014

NPI assigned

Jun 12, 2006

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 identifiers 3

Other names 1

• Kimberly B Oberst Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Interoperability endpoints

• Direct secure messaging: kshelanskey8443@direct.riversidehealthcare.net

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.

• Riverside Health System

  • General Practice Physician
  • Kankakee, IL
  • NPI 1417061193
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1982646139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 RIVERSIDE DR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609144689",
            "telephone_number": "815-933-9660",
            "fax_number": "815-929-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 RIVERSIDE DR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609144689",
            "telephone_number": "815-933-9660",
            "fax_number": "815-929-0014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "482 Main St NW",
            "address_purpose": "LOCATION",
            "city": "Bourbonnais",
            "state": "IL",
            "postal_code": "609142331",
            "country_code": "US",
            "telephone_number": "815-939-4141 x226",
            "fax_number": "815-939-1501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELANSKEY",
        "first_name": "KIMBERLY",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209008580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "KO196003",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01226063",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4671139",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kshelanskey8443@Direct.riversidehealthcare.net",
            "affiliation": "N",
            "endpointDescription": "Riverside Direct, Secure Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "200 Riverside Dr",
            "city": "Bourbonnais",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609144689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "OBERST",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.