BEVERLY J SHAMLOO


Address: 1520 S Liberty Dr, Bloomington, IN 47403-5167
Phone: 8126764500

BEVERLY J SHAMLOO (NPI# 1003399759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1003399759
Entity Type Individual
Full Name BEVERLY J SHAMLOO
Credential NP
Practice Address 1520 S Liberty Dr
Bloomington
IN 47403-5167
Practice Telephone 8126764500
Enumeration Date 2018-09-10
Last Update Date 2020-06-02
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner 71008290A IN Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
2900 16th St, Bedford, IN 474213510 8122788800
7 E Main St, Gosport, IN 474337034 8128794222
926 W State Highway 46, Spencer, IN 47460 8128794222

Office Location

Street Address 1520 S LIBERTY DR
City BLOOMINGTON
State IN
Zip Code 47403-5167

Providers in the same location

NPI Name Taxonomy Address Enumeration
1972505923 Lela C Johnson Internal Medicine 1520 S Liberty Dr, Bloomington, IN 47403 2005-06-02
1407408933 Colin Frank Pharmacist 1520 S Liberty Dr, Bloomington, IN 47403-5167 2019-07-15
1073172532 Stephanie M West Physician Assistant 1520 S Liberty Dr, Bloomington, IN 47403-5167 2019-06-10
1578940151 Ashley Shumate Urology 1520 S Liberty Dr, Bloomington, IN 47403-5167 2015-05-02
1790075596 Amanda Jean Pettibone-pond Urology 1520 S Liberty Dr, Bloomington, IN 47403-5167 2011-04-13
1407186687 Shaun M Altneu Internal Medicine 1520 S Liberty Dr, Bloomington, IN 47403-5167 2010-01-11
1811140064 Laura Bryce Knudson Family Medicine 1520 S Liberty Dr, Bloomington, IN 47403-5167 2008-11-01
1548427123 Paula J Bunde Urology 1520 S Liberty Dr, Bloomington, IN 47403-5167 2008-05-21
1548489834 Heather Dawn Anderson Nurse Practitioner 1520 S Liberty Dr, Bloomington, IN 47403 2007-04-24
1669695367 James Wesley Archer Family Medicine 1520 S Liberty Dr, Bloomington, IN 47403-5167 2007-04-11
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1043783673 Brook Whitaker Registered Nurse 4011 S. Monroe Medical Park Blvd, Bloomington, IN 47403 2019-01-07
1598251175 Jacob Edward Lundorf Nurse Practitioner 2100 S Liberty Dr Ste B, Bloomington, IN 47403 2018-07-06
1568973717 Gregory Thomas Dougan Physician Assistant 418 South Landmark Avenue, Bloomington, IN 47403 2017-10-16
1295276160 Indiana Center for Recovery, LLC Substance Abuse Rehabilitation Facility 1004 W 1st Street, Bloomington, IN 47403 2017-03-13
1144694217 Kayla Dewolf Specialist/Technologist 1471 W Allen St, Bloomington, IN 47403 2015-11-30
1164806444 Monroe Hosoital General Acute Care Hospital 4011 Monroe Medical Park, Bloomington, IN 47403 2015-07-16
1821411588 Jennifer Turner Occupational Therapy Assistant 1023 West Main St, Swiss Villa, Vevay, IN 47403 2014-01-30
1104170232 Kendall Basore Social Worker 445 S. Landmark Ave., Bloomington, IN 47403 2012-10-26
1568715886 Indiana Hearing LLC Hearing Aid Equipment 2019 S Liberty Dr, Bloomington, IN 47403 2012-10-24
1679870232 Accurate Hearing Services Clinic/Center 1355 W Second St, #3, Bloomington, IN 47403 2011-02-17
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1821615485 Denise Michelle Alexander Nurse Practitioner 815 West 2nd Street, Bloomington, IN 47403-2212 2020-06-30
1578198420 Jessica Ashley Wargo Nurse Practitioner 1319 N Veterans Pkwy Ste 3b, Bloomington, IL 61704-6428 2020-03-10
1598251175 Jacob Edward Lundorf Nurse Practitioner 2100 S Liberty Dr Ste B, Bloomington, IN 47403 2018-07-06
1275084170 Christina Lisowski Nurse Practitioner 2412 E Washington St Ste 4b, Bloomington, IL 61704-1613 2016-10-17
1528479771 Cura Medical Group, LLC Nurse Practitioner 13 Red Stone Ct, Bloomington, IL 61704-8403 2014-05-09
1790118586 Anastasia Kovalaske Nurse Practitioner 1401 Eastland Dr Suite B, Bloomington, IL 61761-3514 2013-08-15
1528342730 Theresa Rose Woodard Nurse Practitioner 3209 W Fullerton Pike Ste E, Bloomington, IN 47403-4060 2011-10-06
1205160975 Stacey Kaye England Nurse Practitioner 123 S Franklin Rd, Bloomington, IN 47404-5296 2009-09-28
1700065505 Joan Marie Goodman Nurse Practitioner 383 S. Park Ridge Rd., Ste 102, Bloomington, IN 47401-8574 2007-10-29
1376638262 Rose M Seguin Nurse Practitioner 421 S College Ave, Bloomington, IN 47403-1514 2006-10-04
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Competitor

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City BLOOMINGTON
Zip Code 47403

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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