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DR. KENNETH RYAN SHACKELFORD DNP, APRN, FNP-BC
NPI 1811774417
Nurse Practitioner - Family in Festus, MO

Active since September 08, 2023PECOS EnrolledAccepts Medicare Assignment
1405 N TRUMAN BLVD, FESTUS, MO 63028(636) 933-2243 Get Directions Write a Review

NPPES record last updated: September 8, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kenneth Ryan Shackelford Dnp, Aprn, Fnp-bc NPPES

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

DR. KENNETH RYAN SHACKELFORD DNP, APRN, FNP-BC (NPI 1811774417) is an individual family provider in Festus, Missouri, licensed in Missouri (2023036843) and active in the NPI registry since September 2023. He is enrolled in Medicare PECOS, is affiliated with Mercy Hospital St Louis, and maintains a secondary practice location in Chesterfield.

NPPES Registry Identity

NPI1811774417
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameDR. KENNETH RYAN SHACKELFORDCredential: DNP, APRN, FNP-BC
Location Address1405 N TRUMAN BLVDFestus, MO 63028-1177
Mailing Address16607 Evergreen Forest DrWildwood, MO 63011-1800 · (314) 379-4344
Phone(636) 933-2243
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateSeptember 8, 2023
NPPES CertifiedSeptember 8, 2023
✔ NPI 1811774417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MO · 2023036843
1405 N TRUMAN BLVD, Festus, MO 63028
Open in Google Maps ↗

Other Names 1

Former Name (1)Kenneth Ryan Hess

Secondary Practice Location 1

Location 1500 Chesterfield Ctr Ste 250Chesterfield, MO 63017-4833 · Phone (636) 519-8889

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

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

Dr. Kenneth Ryan Shackelford Dnp, Aprn, Fnp-bc 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 ID5890141915
PECOS Enrollment IDI20231026000886
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 7

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
482 services216 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.
283 services182 patients
Testing for presence of drug, by chemistry analyzers 80307
Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.
73 services58 patients
Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming 95972
This procedure involves electronically analyzing an implanted neurostimulator. This device sends electrical pulses to your spinal cord or peripheral nerves to manage pain. The programming is complex, requiring expert analysis to ensure proper functioning.
38 services27 patients
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms G0482
A definitive drug test identifies specific drugs in your system. Advanced methods like GC/MS (Gas Chromatography/Mass Spectrometry) and LC/MS (Liquid Chromatography/Mass Spectrometry) are used. These can distinguish between similar drugs, providing precise results.
27 services22 patients
Smoking and tobacco use intensive counseling, 4-10 minutes 99406
This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.
25 services14 patients

Hospital Affiliations CMS Care Compare 4

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

Mercy Hospital St Louis

Acute Care Hospitals · Saint Louis, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260020
Location615 New Ballas RoadSaint Louis, MO 63141 · St. Louis County
Emergency services Birthing friendly

Mercy Hospital South

Acute Care Hospitals · Saint Louis, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260077
Location10010 Kennerly RoadSaint Louis, MO 63128 · St. Louis County
Emergency services

Ssm Health Depaul Hospital St Louis

Acute Care Hospitals · Bridgeton, MO
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number260104
Location12303 Depaul DriveBridgeton, MO 63044 · St. Louis County
Emergency services Birthing friendly

St Lukes Hospital

Acute Care Hospitals · Chesterfield, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260179
Location232 S Woods Mill RdChesterfield, MO 63017 · St. Louis County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63028 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.

Other Providers at the Same Location NPPES 3

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

LARA TAYLOR APRN FNP-C
Nurse Practitioner
1405 N TRUMAN BLVD
FESTUS, MO 63028
Jefferson County (636) 933-2243
INTERVENTIONAL PAIN INSTITUTE, LLC
Specialist
1405 N TRUMAN BLVD
FESTUS, MO 63028
Jefferson County (636) 933-2243
MINDY KAY WORTMANN NP
Nurse Practitioner
1405 N TRUMAN BLVD
FESTUS, MO 63028
Jefferson County (636) 933-2243

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 Kenneth Shackelford's NPI number?

The NPI number for Kenneth Shackelford is 1811774417. It was assigned to this individual provider in the NPPES registry on September 8, 2023. The provider is also known as Kenneth Ryan Hess.

Where is Kenneth Shackelford located?

Kenneth Shackelford practices at 1405 N Truman Blvd, Festus, MO 63028. The listed phone number is (636) 933-2243.

What is Kenneth Shackelford's specialty?

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

Is Kenneth Shackelford enrolled in Medicare?

Yes. Kenneth Shackelford is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kenneth Shackelford accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 4 other insurers list Kenneth Shackelford as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kenneth Shackelford affiliated with any hospitals?

According to CMS data, Kenneth Shackelford is affiliated with Mercy Hospital St Louis, Mercy Hospital South, Ssm Health Depaul Hospital St Louis and St Lukes Hospital.

When was this NPI record last updated?

The NPPES record for Kenneth Shackelford was last updated on September 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.