SHAWNEE LYNN KELLISON RNBCFNP
NPI 1063495463
Nurse Practitioner - Family in Kirksville, MO
About Shawnee Lynn Kellison Rnbcfnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHAWNEE LYNN KELLISON RNBCFNP (NPI 1063495463) is an individual family provider in Kirksville, Missouri, licensed in Missouri (113721) and active in the NPI registry since November 2005. She has opted out of Medicare through April 1, 2028.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 5
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Shawnee Lynn Kellison Rnbcfnp has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2026 through April 1, 2028.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
KIRKSVILLE, MO 63501
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 Shawnee Kellison's NPI number?
The NPI number for Shawnee Kellison is 1063495463. It was assigned to this individual provider in the NPPES registry on November 21, 2005.
Where is Shawnee Kellison located?
Shawnee Kellison practices at 700 W Jefferson St, Kirksville, MO 63501. The listed phone number is (660) 626-2191.
What is Shawnee Kellison's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Shawnee Kellison enrolled in Medicare?
No. Shawnee Kellison has opted out of Medicare through April 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Shawnee Kellison was last updated on February 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Shawnee Lynn Kellison, RNBCFNP · NPI 1063495463
Family physician in Kirksville, Missouri. Individual provider, active in the CMS NPPES registry since November 21, 2005.
## Identity
- **NPI:** 1063495463 (Entity type: Individual)
- **Enumerated:** November 21, 2005
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 113721 (Missouri)
- **Sole proprietor:** No
## Practice location
- **Address:** 700 W JEFFERSON ST, Kirksville, MO 63501-1441
- **Phone:** (660) 626-2191 · **Fax:** (660) 626-2396
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through April 1, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** February 2, 2026
- **Other identifiers:** Other 501218200 (MO); Medicaid 428713812 (MO); Other DG4290 (MO); and 2 more
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Source: [NPI Profile](https://npiprofile.com/npi/1063495463) · Data from the CMS NPPES public registry.