KELLIE L SHUCK (NPI# 1598720534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598720534 |
| Entity Type | Individual |
| Full Name | KELLIE L SHUCK |
| Credential | PMHNP-CNS, BC |
| Practice Address |
1001 W Worley St Columbia MO 65203-2037 |
| Practice Telephone | 5732142314 |
| Practice Fax Number | 5738142835 |
| Mailing Telephone | 5732142314 |
| Mailing Fax Number | 5738142835 |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2019-07-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
2000161947 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 427531801 | 05 |
| Street Address |
1001 W WORLEY ST |
| City | COLUMBIA |
| State | MO |
| Zip Code | 65203-2037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245238005 | Andrew C Quint | Internal Medicine | 1001 W Worley St, Columbia, MO 65203-2037 | 2005-07-14 |
| 1336747773 | Renee Michelle Shaw | Social Worker | 1001 W Worley St, Columbia, MO 65203-2037 | 2020-10-16 |
| 1386242832 | Brenda Pummill | Dental Hygienist | 1001 W Worley St, Columbia, MO 65203-2037 | 2020-10-15 |
| 1164048500 | Margaret Brennan | Family Medicine | 1001 W Worley St, Columbia, MO 65203-2037 | 2020-06-22 |
| 1467078832 | Airika Danielle Poivre | Family Medicine | 1001 W Worley St, Columbia, MO 65203-2037 | 2020-06-22 |
| 1225690019 | Nancy Jane Forgy | Nurse Practitioner | 1001 W Worley St, Columbia, MO 65203-2037 | 2019-07-02 |
| 1376105346 | Eva Veronika Kiss | Family Medicine | 1001 W Worley St, Columbia, MO 65203-2037 | 2019-07-01 |
| 1851853519 | Leslye Gayle Schulte | Nurse Practitioner | 1001 W Worley St, Columbia, MO 65203-2037 | 2019-04-02 |
| 1649744079 | Emily D Anderson | Social Worker | 1001 W Worley St, Columbia, MO 65203-2037 | 2019-01-18 |
| 1205308236 | Family Health Center of Boone County | Clinic/Center | 1001 W Worley St, Columbia, MO 65203-2037 | 2019-01-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982229498 | Rebecca Wallace Counseling LLC | Clinic/Center | 207 Peach Way, Suite 110, Columbia, MO 65203 | 2020-06-10 |
| 1144797101 | Mary Zhang | Family Medicine | 200 Southampton Drive, Ste 102, Columbia, MO 65203 | 2018-10-29 |
| 1871090258 | Hina Omer Khokhar | Pathology | 4601 Apt F West Millbrook Dr, Columbia, MO 65203 | 2018-04-11 |
| 1154820157 | David Vincent Spencer | Internal Medicine | 201 W Broadway Building, Suite E, Columbia, MO 65203 | 2018-02-05 |
| 1598283103 | Donna Strickland | Counselor | 201 W Broadway Bldg 2, Suite F, Columbia, MO 65203 | 2017-09-03 |
| 1134643182 | Anna Kathryn Christensen | Physician Assistant | 4107 Baurichter Dr., Columbia, MO 65203 | 2017-08-01 |
| 1558885871 | Juan Camilo Pineda | Internal Medicine | 210 Portland Street Suite 104, Columbia, MO 65203 | 2017-07-28 |
| 1922530096 | The Missing L Inc | Community/Behavioral Health | 3605 S. Providence Rd, Suite 6, Columbia, MO 65203 | 2017-03-29 |
| 1689118010 | Linda Landry | Nurse Practitioner | 1000 W. Nifong, Bldg 2 Suite 150, Columbia, MO 65203 | 2016-12-04 |
| 1417313552 | Brittany Lea Ramirez | Chiropractor | 2001 Corona Rd Ste 205, Columbia, MO 65203 | 2016-01-05 |
| Find all providers in zip 65203 | ||||
| Taxonomy Code | 364SP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184849143 | Myrna E. C. Carpenter | Clinical Nurse Specialist | 10632 Little Patuxent Pkwy, Suite 308a, Columbia, MD 21044-3273 | 2007-04-16 |
| 1598713208 | Margaret Ann Yoest | Clinical Nurse Specialist | 551 E Southampton Dr, Columbia, MO 65201-4236 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780848747 | Moniteau Mental Health Care | Clinical Nurse Specialist | 320 S Oak St, California, MO 65018-1824 | 2008-07-17 |
| 1598753337 | Linda E Miller | Clinical Nurse Specialist | 810 Derhake Rd, Florissant, MO 63033-5823 | 2005-10-06 |
| 1316934516 | Barbara J Mcdowell | Clinical Nurse Specialist | 121 Civic Center Dr, Suite 222, Lake St Louis, MO 63367-3027 | 2005-10-03 |
| 1508254954 | Cindy A Mayberry Apn LLC | Clinical Nurse Specialist | 705 E Laharpe St Ste D, Kirksville, MO 63501-4526 | 2015-01-07 |
| 1326334087 | Marie T Conner | Clinical Nurse Specialist | 1301 Industrial Pkwy E, El Dorado Springs, MO 64744-6263 | 2011-06-21 |
| 1144457144 | Judith Ann Tubbs | Clinical Nurse Specialist | 211 Ne 54th St, Suite 201, Kansas City, MO 64118-4390 | 2009-06-17 |
| 1154572808 | Peggy Curry Gleason | Clinical Nurse Specialist | 1 Jefferson Barracks Dr, Department of Veterans Affairs Medical Center, Saint Louis, MO 63125-4181 | 2008-09-30 |
| 1841214335 | Margaret J Brothers | Clinical Nurse Specialist | 1085 Maple St, Farmington, MO 63640-1955 | 2006-07-27 |
| 1841234275 | Freeman-oak Hill Health System | Clinical Nurse Specialist | 1102 W 32nd St, Joplin, MO 64804-3503 | 2006-06-15 |
| 1669430591 | Barbara Scheiper Latal | Clinical Nurse Specialist | 1 Jefferson Barracks Dr, Saint Louis, MO 63125-4181 | 2006-05-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.