MR. SHAWN THEBERGE APRN, FNP-C, NR-P
NPI 1205447455
Nurse Practitioner - Family in Wales, WI

Q: What is Shawn Theberge's NPI number?

The NPI number for Shawn Theberge is 1205447455. It was assigned to this individual provider in the NPPES registry on August 12, 2020.

Q: What is Shawn Theberge's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Shawn Theberge was last updated on August 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.

Active since August 12, 2020PECOS Enrolled

200 W SUMMIT AVE, WALES, WI 53183(207) 650-7540 Get Directions Write a Review

NPPES record last updated: August 3, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 3, 2021, Aug 13, 2020 (2 updates tracked since 2020).

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About Mr. Shawn Theberge Aprn, Fnp-c, Nr-p NPPES

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

MR. SHAWN THEBERGE APRN, FNP-C, NR-P (NPI 1205447455) is an individual family provider in Wales, Wisconsin, licensed in Maine (CNP201467) and active in the NPI registry since August 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205447455

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameMR. SHAWN THEBERGECredential: APRN, FNP-C, NR-P

Location Address200 W SUMMIT AVEWales, WI 53183-9427

Mailing Address11 Canyon WayWindham, ME 04062-4895 · (207) 650-7540

Phone(207) 650-7540

Sole ProprietorYes

Enumeration DateAugust 12, 2020

Last NPPES UpdateAugust 3, 20212 updates tracked since enumeration

NPPES CertifiedAugust 3, 2021

✔ NPI 1205447455 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in ME · CNP201467

Also ListedEmergency Medical Technician, ParamedicTaxonomy 146L00000X · License P8036707 (ME)

Also ListedRegistered NurseTaxonomy 163W00000X · License RN72498 (ME)

200 W SUMMIT AVE, Wales, WI 53183

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Shawn Theberge Aprn, Fnp-c, Nr-p 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53183 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

HOPE COUNSELING CENTER, LLC

Community/Behavioral Health

200 W SUMMIT AVE, SUITE 220
WALES, WI 53183

Waukesha County (262) 271-3255

SONIA LYNN WICHMANN LPC, LMFT

Marriage & Family Therapist

200 W SUMMIT AVE
WALES, WI 53183

Waukesha County (262) 433-6673

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 Shawn Theberge's NPI number?

The NPI number for Shawn Theberge is 1205447455. It was assigned to this individual provider in the NPPES registry on August 12, 2020.

Where is Shawn Theberge located?

Shawn Theberge practices at 200 W Summit Ave, Wales, WI 53183. The listed phone number is (207) 650-7540.

What is Shawn Theberge's specialty?

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

Is Shawn Theberge enrolled in Medicare?

Yes. Shawn Theberge is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shawn Theberge was last updated on August 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.