SHANA CLARKSON (NP) – Nurse Practitioner, NPI 1053952515

SHANA CLARKSON (NP) is a healthcare provider. based in Quincy, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 209020182 (IL). The NPI Number for SHANA CLARKSON (NP) is 1053952515

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
SHANA CLARKSON (NP)
NPI
1053952515
Phone
(217) 223-1200
Address
1005 Broadway St
Enumeration Date
4 October 2019
Last Update Date
17 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2172149626
Graduation Year
2019 (7 years ago)
PAC ID
3577905991
Group Practice PAC ID
3072422534
Professional Enrollment ID
I20240530001011
Address ID
IL623017431QU420XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for SHANA CLARKSON (NP)

  • 1005 Broadway St

    Quincy, IL 623012834

    Phone: (217) 223-1200

    Type: Location

  • 2500 ROUTE 99

    MT. STERLING, IL 623533552

    Phone: (217) 773-4441

    Type: Mailing

  • 1005 BROADWAY ST

    QUINCY, IL 623012834

    Phone: (217) 223-1200

    Type: Mailing

  • 2500 ROUTE 99 S

    MT STERLING, IL 623531462

    Phone: (217) 773-4441

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-05-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240530001011INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62301)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3072422534View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YIL
Nurse PractitionerIL
N E U R O L O G YMI
Radiation OncologyIL
Nurse PractitionerIL
Pain Management, AnesthesiologyIL
Family Practice, Emergency MedicineIL
Nurse PractitionerIL
Family PracticeIL
Emergency MedicineIL

Reviews

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Frequently asked questions

Can I use this page to confirm SHANA CLARKSON (NP)'s NPI?
Yes. SHANA CLARKSON (NP) is listed with NPI 1053952515 in the public NPI dataset.
Does CMS list SHANA CLARKSON (NP) as active?
Yes — SHANA CLARKSON (NP) is active in the NPI listing used on this page.
What taxonomy line describes SHANA CLARKSON (NP)?
For research purposes, treat SHANA CLARKSON (NP) as Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What area does SHANA CLARKSON (NP) serve?
SHANA CLARKSON (NP)'s listing highlights Quincy, Illinois; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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