NICHOLAS KYLE SHOCKLEY FNP
NPI 1649766288
Nurse Practitioner - Family in Saint Louis, MO

Q: What is Nicholas Shockley's NPI number?

The NPI number for Nicholas Shockley is 1649766288. It was assigned to this individual provider in the NPPES registry on July 6, 2018.

Q: What is Nicholas Shockley'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 Nicholas Shockley was last updated on April 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since July 06, 2018PECOS EnrolledAccepts Medicare Assignment

75.73/100

CMS Quality Rating

10012 KENNERLY RD STE 406, SAINT LOUIS, MO 63128(314) 525-1224(314) 525-4957 Get Directions Write a Review

NPPES record last updated: April 29, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 29, 2026, Feb 10, 2025, Feb 3, 2023 and 2 more (5 updates tracked since 2018).

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About Nicholas Kyle Shockley Fnp NPPES

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

NICHOLAS KYLE SHOCKLEY FNP (NPI 1649766288) is an individual family provider in Saint Louis, Missouri, licensed in Missouri (2021027097) and active in the NPI registry since July 2018. He is enrolled in Medicare PECOS, is affiliated with Herrin Hospital, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1649766288

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameNICHOLAS KYLE SHOCKLEYCredential: FNP

Location Address10012 KENNERLY RD STE 406Saint Louis, MO 63128-2197

Mailing Address10012 Kennerly Rd Ste 406Saint Louis, MO 63128-2197 · (314) 525-1224 · Fax (314) 525-4957

Phone(314) 525-1224

Fax(314) 525-4957

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateJuly 6, 2018

Last NPPES UpdateApril 29, 20265 updates tracked since enumeration

NPPES CertifiedApril 29, 2026

✔ NPI 1649766288 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 MO · 2021027097✔ Licensed in IL · 209.017506

Also ListedNurse PractitionerTaxonomy 363L00000X · License 209017506 (IL)

10012 KENNERLY RD STE 406, Saint Louis, MO 63128

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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 and accepts Medicare assignment

Nicholas Kyle Shockley Fnp 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 ID8123370509

PECOS Enrollment IDI20181012000980

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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

112 services63 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

33 services33 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

15 services15 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

12 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Herrin Hospital

Acute Care Hospitals · Herrin, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140011

Location201 S 14th StHerrin, IL 62948 · Williamson County

Emergency services

Memorial Hospital Of Carbondale

Acute Care Hospitals · Carbondale, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140164

Location405 W JacksonCarbondale, IL 62901 · Jackson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63128 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75.73/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

63.09

Promoting Interoperability

100

Improvement Activities

Cost

45.26

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

8 suppliers24 claims68 services$5.79 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 19

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

KAITLYN STURMER PA-C

Physician Assistant