Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.
MARSHA D SHIVLEY FNP
Complete NPI Record 1083705487
Nurse Practitioner - Family in Poplar Bluff, MO
Active since September 28, 2006PECOS Enrolled
Complete NPI Dataset
This page contains the complete raw NPPES record for Marsha D Shivley, FNP (NPI 1083705487), an individual nurse practitioner provider in Poplar Bluff, MO. All 29 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1083705487 Field 1/29
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/29
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: SHIVLEY Field 3/29
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: MARSHA Field 4/29
- The first name of the provider, if the provider is an individual.
- Provider Middle Name: D Field 5/29
- The middle name of the provider, if the provider is an individual.
- Provider Credential Text: FNP Field 6/29
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: 110 S 2ND ST Field 7/29
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: ELLINGTON Field 8/29
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: MO Field 9/29
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 636389400 Field 10/29
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/29
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 5736632313 Field 12/29
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 5736632441 Field 13/29
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 2210 BARRON RD STE 120 Field 14/29
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: POPLAR BLUFF Field 15/29
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: MO Field 16/29
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 639011922 Field 17/29
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 18/29
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 5737856536 Field 19/29
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 5737850100 Field 20/29
- The fax number associated with the location address of the provider being identified.
- Provider Gender Code: F Field 23/29
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 363LF0000X Field 24/29
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 075449 Field 25/29
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: MO Field 26/29
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 27/29
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Sole Proprietor: N Field 28/29
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 25
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
109 LeRoux St
Location 1/25Doniphan, MO 63935-1038 · Phone (573) 996-2136 · Fax (573) 996-5216
405 Main Street
Location 2/25Van Buren, MO 63965 · Phone (573) 323-4253 · Fax (573) 323-0154
225 Physicians Park Ste 104
Location 3/25Poplar Bluff, MO 63901-3918 · Phone (573) 413-4065 · Fax (573) 354-5013
109 Plum St Ste C
Location 4/25Doniphan, MO 63935-1225 · Phone (573) 351-0150
225 Physicians Park Ste 304
Location 5/25Poplar Bluff, MO 63901-3930 · Phone (573) 727-5500 ext. 6 · Fax (573) 399-2646
2210 Barron Rd Ste 222
Location 6/25Poplar Bluff, MO 63901-1906 · Phone (573) 351-0138 · Fax (573) 609-8713
711 Nickey St
Location 7/25Poplar Bluff, MO 63901-6544 · Phone (573) 785-7047 ext. 13040 · Fax (573) 413-4192
17959 Main St
Location 8/25Eminence, MO 65466-6375 · Phone (573) 226-5505 · Fax (573) 226-1256
220 East Broad Street
Location 9/25Naylor, MO 63953 · Phone (573) 399-2311 · Fax (573) 399-2076
2879 James Blvd
Location 10/25Poplar Bluff, MO 63901-3395 · Phone (573) 712-1610 · Fax (573) 776-6124
603 E Summit St
Location 11/25Doniphan, MO 63935-1142 · Phone (573) 996-3667 ext. 1117 · Fax (573) 413-4487
101 E Batten Street
Location 12/25Naylor, MO 63953 · Phone (573) 804-1779 · Fax (573) 804-1789
225 Physicians Park Ste 102
Location 13/25Poplar Bluff, MO 63901-3918 · Phone (573) 727-5500 ext. 2 · Fax (573) 413-4609
225 Physicians Park Ste 200
Location 14/25Poplar Bluff, MO 63901-3921 · Phone (573) 727-5500 ext. 5 · Fax (573) 313-3684
109 Plum St Ste B
Location 15/25Doniphan, MO 63935-1225 · Phone (573) 351-0220 · Fax (573) 996-2246
1300 Victory Ln
Location 16/25Poplar Bluff, MO 63901-3300 · Phone (573) 785-5566 ext. 17097 · Fax (573) 413-4194
109 Plum St Ste A
Location 17/25Doniphan, MO 63935-1225 · Phone (573) 351-0150 · Fax (573) 996-2245
202 Allen St
Location 18/25Annapolis, MO 63620-8778 · Phone (573) 598-4213 · Fax (573) 598-1101
11001 US-160
Location 19/25Harviell, MO 63945 · Phone (573) 804-9561 · Fax (573) 804-9581
2300 Baugh Ln
Location 20/25Poplar Bluff, MO 63901-2402 · Phone (573) 785-3037 ext. 16044 · Fax (573) 413-4506
289 Broadway St
Location 21/25Neelyville, MO 63954-7176 · Phone (573) 804-9494 · Fax (573) 804-9493
3277 US Highway 160 W
Location 22/25Doniphan, MO 63935-5710 · Phone (573) 804-9527 · Fax (573) 804-9536
1 Hals Plz Ste A
Location 23/25Piedmont, MO 63957-1631 · Phone (573) 223-4800 · Fax (573) 223-7911
61 Highway Y
Location 24/25Ellington, MO 63638-7802 · Phone (573) 663-2525 · Fax (573) 663-7844
315 W Mulberry Ste A
Location 25/25Pilot Knob, MO 63663-7883 · Phone (573) 546-0602 · Fax (573) 546-0546
No registry entries match your active lookup criteria.
