SHABORI SHANAE SMITH
NPI 1053160747
Nurse Practitioner in Saint Louis, MO

Active since May 15, 2024PECOS EnrolledAccepts Medicare Assignment
11125 DUNN RD STE 406, SAINT LOUIS, MO 63136(314) 653-5484 Get Directions Write a Review

NPPES record last updated: September 26, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 19, 2025, Jan 6, 2025, May 15, 2024 (3 updates tracked since 2024).

About Shabori Shanae Smith NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHABORI SHANAE SMITH (NPI 1053160747) is an individual nurse practitioner in Saint Louis, Missouri, licensed in Missouri (2024014462) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in Saint Louis, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1053160747
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameSHABORI SHANAE SMITH
Location Address11125 DUNN RD STE 406Saint Louis, MO 63136-6132
Mailing Address11155 Dunn Rd Ste 406Saint Louis, MO 63136-6150 · (314) 653-5484
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateMay 15, 2024
Last NPPES UpdateSeptember 26, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 26, 2025
NPI 1053160747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in MO · 2024014462
Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

11125 DUNN RD STE 406, Saint Louis, MO 63136

Secondary Practice Location 1

Location 111155 Dunn Rd Ste 406Saint Louis, MO 63136-6150 · Phone (314) 653-5484

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Shabori Shanae Smith is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4486192119
PECOS Enrollment IDI20240813002903
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63136 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Obstetrics & Gynecology
11125 DUNN RD STE 406
SAINT LOUIS, MO 63136
Nurse Practitioner (Family)
11125 DUNN RD STE 406
SAINT LOUIS, MO 63136
Nurse Practitioner
11125 DUNN RD STE 406
SAINT LOUIS, MO 63136
Nurse Practitioner (Family)
11125 DUNN RD STE 406
SAINT LOUIS, MO 63136
Family Medicine
11125 DUNN RD STE 406
SAINT LOUIS, MO 63136

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shabori Smith's NPI number?

The NPI number for Shabori Smith is 1053160747. It was assigned to this individual provider in the NPPES registry on May 15, 2024.

Where is Shabori Smith located?

Shabori Smith practices at 11125 Dunn Rd Ste 406, Saint Louis, MO 63136. The listed phone number is (314) 653-5484.

What is Shabori Smith's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Shabori Smith enrolled in Medicare?

Yes. Shabori Smith is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Shabori Smith was last updated on September 26, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.