Shane T Eberhardt, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

G173329 Issued in IA

Practice address

400 S Broadway St
Burlington, IA 52601-9407

Phone

(319) 768-5858

NPI assigned

Feb 13, 2023

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

Enrolled in IA

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Centers of Southeastern Iowa IncGroup PAC ID 4486562527, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Iowa Regional Medical Center Hospital, West Burlington, IA, CCN 160057

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: seberhardt639113@direct.ochin.org

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.

• Community Health Centers of Southeastern Iowa Inc

  • Federally Qualified Health Center (FQHC)
  • West Burlington, IA
  • NPI 1255339750
  Medicare reassignment Care Compare group NPD
• Community Health Centers of Southeastern Iowa, Inc

  • Federally Qualified Health Center (FQHC)
  • West Burlington, IA
  • NPI 1144044637
  NPD
• Community Health Centers of Southeastern Iowa, Inc

  • Federally Qualified Health Center (FQHC)
  • Burlington, IA
  • NPI 1962192401
  NPD

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

• Southeast Iowa Regional Medical Center, Inc.

  • General Acute Care Hospital
  • West Burlington, IA
  • NPI 1134168263
  Care Compare affiliation

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1992402655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 W AGENCY RD",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551667",
            "telephone_number": "319-768-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S BROADWAY ST",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526019407",
            "telephone_number": "319-768-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERHARDT",
        "first_name": "SHANE",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-13",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G173329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chris Alan Dobbe, TLMHC
• Patti Dobbe, TLMHC
• Ezra Douglas, PHARMD.
• Melissa Ann Douglas, PHARM D
• Heather Duncan
• Ron W Eccles, DC
• Emily K Eisenmann, D.C.
• Stephanie Jo Ellis
• Janelle Leigh Engstrom, LISW
• Alan Howard Fabel, LISW

• Psychiatric/Mental Health Nurse Practitioner in Burlington, IA
• Providers in Burlington, IA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; 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.