ELIZABETH SHALLENBERGER (APRN) – Nurse Practitioner, NPI 1104300094
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for ELIZABETH SHALLENBERGER (APRN)
Main Street, Saint Anna, Town of New Holstein, Calumet County, Wisconsin, 53061, United States
ANNA, IL 629061668
Phone: (618) 833-4511
Fax: (618) 833-2414
Type: Location
1520 CEDAR GROVE RD
BUNCOMBE, IL 629122052
Phone: (618) 201-5926
Fax: (618) 833-6267
Type: Mailing
513 N Main St
Anna, IL 629061697
Phone: (618) 833-4471
Fax: (618) 833-6267
Type: Location
211 N Broadway
Goreville, IL 629392323
Phone: (618) 995-1002
Fax: (618) 833-6267
Type: Location
803 N 1ST ST
VIENNA, IL 629951544
Phone: (618) 658-2811
Fax: (618) 833-6267
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $124.
Total Amount is formed as General ($124) + Research ($0) + Ownership ($0) = $124.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Axsome Therapeutics, Inc. ($77).
Total Amount
$124
General + Research + Ownership
Payments
4
Total payment records
General Amount
$124
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2019-03-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20181113002809 | I | Nurse Practitioner | IL | TBD |
| I20190306001814 | I | Nurse Practitioner | MO | TBD |
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.
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 62906)
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Reviews
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