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ELIZABETH SHALLENBERGER APRN
NPI 1104300094
Nurse Practitioner - Family in Vienna, IL

Active since September 18, 2018PECOS Enrolled
803 N 1ST ST, VIENNA, IL 62995(618) 658-2811(618) 833-6267 Get Directions Write a Review

NPPES record last updated: August 17, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Aug 17, 2026, Aug 14, 2026, Sep 4, 2024 and 3 more (6 updates tracked since 2018).

About Elizabeth Shallenberger Aprn NPPES

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

ELIZABETH SHALLENBERGER APRN (NPI 1104300094) is an individual family provider in Vienna, Illinois, licensed in Illinois (277005812) and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1104300094
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameELIZABETH SHALLENBERGERCredential: APRN
Location Address803 N 1ST STVienna, IL 62995-1544
Mailing Address1520 Cedar Grove RdBuncombe, IL 62912-2052 · (618) 201-5926 · Fax (618) 833-6267
Phone(618) 658-2811
Fax(618) 833-6267
Sole ProprietorNo
Enumeration DateSeptember 18, 2018
Last NPPES UpdateAugust 17, 20266 updates tracked since enumeration
NPPES CertifiedAugust 17, 2026
✔ NPI 1104300094 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in IL · 277005812✔ Licensed in IL · 209018052
Also ListedNurse PractitionerTaxonomy 363L00000X · License 209018052 (IL)
803 N 1ST ST, Vienna, IL 62995
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1513 N Main StAnna, IL 62906-1697 · Phone (618) 833-4471 · Fax (618) 833-6267
Location 2211 N BroadwayGoreville, IL 62939-2323 · Phone (618) 995-1002 · Fax (618) 833-6267

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elizabeth Shallenberger Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Elizabeth Shallenberger reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Rural Health, Inc.
20 mi
Federally Qualified Health Center (FQHC)
513 N MAIN ST
Anna, IL 62906
  • Reassigned Medicare billing, Illinois enrollment
  • 28 clinicians in this Medicare group
NPI 1982666384 (618) 833-4471
Southeast Missouri Hospital Physicians, LLC
36 mi
Family Medicine
1701 LACEY ST
Cape Girardeau, MO 63701
  • Reassigned Medicare billing, Missouri enrollment
  • 470 clinicians in this Medicare group
NPI 1558311522 (573) 331-6880

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62995 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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 2

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

RURAL HEALTH, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
803 N 1ST ST
VIENNA, IL 62995
Johnson County (618) 658-2811
DENA C TAYLOR NP-C
Nurse Practitioner (Family)
803 N 1ST ST
VIENNA, IL 62995
Johnson County (618) 658-2811

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 Elizabeth Shallenberger's NPI number?

The NPI number for Elizabeth Shallenberger is 1104300094. It was assigned to this individual provider in the NPPES registry on September 18, 2018.

Where is Elizabeth Shallenberger located?

Elizabeth Shallenberger practices at 803 N 1st St, Vienna, IL 62995. The listed phone number is (618) 658-2811.

What is Elizabeth Shallenberger's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Elizabeth Shallenberger enrolled in Medicare?

Yes. Elizabeth Shallenberger is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Elizabeth Shallenberger's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elizabeth Shallenberger reassigns Medicare benefits to 2 organizations: Rural Health, Inc. (Anna, IL) and Southeast Missouri Hospital Physicians, LLC (Cape Girardeau, MO). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Elizabeth Shallenberger's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Elizabeth Shallenberger was last updated on August 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.