Shane D Parish, MSN, APRN. AGNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

2017038120 Issued in MO

Practice address

1585 Woodlake Dr Ste 111
Chesterfield, MO 63017-5740

Phone

(314) 645-6840

Fax

(314) 628-1046

NPI assigned

Oct 30, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1992217020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 WOODLAKE DR STE 111",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175740",
            "telephone_number": "314-645-6840",
            "fax_number": "314-628-1046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 WOODLAKE DR STE 111",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175740",
            "telephone_number": "314-645-6840",
            "fax_number": "314-628-1046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARISH",
        "first_name": "SHANE",
        "middle_name": "D",
        "credential": "MSN, APRN. AGNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-30",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2017038120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• John Y Park, MD
• Stephanie Park, M.D.
• Anna Jane Parker, PLMFT
• Christine A Parker, PT
• Nicole Lynn Parker, RN, PMHNP

• Primary Care Nurse Practitioner in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Primary Care Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2017; 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.