SHIRLISA LOVE – Psychiatric/Mental Health Nurse Practitioner, NPI 1104691815

SHIRLISA LOVE is a healthcare provider. based in Belleville, Illinois. specializing in NURSE PRACTITIONER. They hold a License No. 2023046705 (MO). The NPI Number for SHIRLISA LOVE is 1104691815

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
SHIRLISA LOVE
NPI
1104691815
Phone
(161) 855-0502
Address
112 MEADOWCREST DR
Enumeration Date
22 November 2023
Last Update Date
8 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7084488470
Graduation Year
2023 (3 years ago)
PAC ID
1052836574
Group Practice PAC ID
3577895176
Professional Enrollment ID
I20250506002945
Address ID
IL604631181PA7300XDRXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:2State licenses:2Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for SHIRLISA LOVE

  • 112 MEADOWCREST DR

    BELLEVILLE, IL 622216749

    Phone: (161) 855-0502

    Type: Mailing

  • MENARD CORRECTIONAL CENTER

    711 E KASKASKIA ST.

    MENARD, IL 62259

    Phone: (618) 826-5071

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 15 Open Payments records for all available years, with a total value of $254.

Total Amount is formed as General ($254) + Research ($0) + Ownership ($0) = $254.

Last reported payment date: 2024-11-26 • Largest payer in this snapshot: ABBVIE INC. ($167).

Total Amount

$254

General + Research + Ownership

Payments

15

Total payment records

General Amount

$254

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-26

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2025-05-06

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
I20250506002945INurse 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 62221)

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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: 3577895176View full group profile
NameSpecialtyState
Nurse PractitionerIL
Nurse PractitionerNJ
Nurse PractitionerIL
Nurse PractitionerWI
Nurse PractitionerIL
Mental Health CounselorIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

What is SHIRLISA LOVE's NPI number?
SHIRLISA LOVE's NPI is 1104691815 — the number used across U.S. healthcare to identify this provider.
Is SHIRLISA LOVE shown as active in public data?
Registry records indicate SHIRLISA LOVE maintains an active NPI.
What expertise is attributed to SHIRLISA LOVE?
SHIRLISA LOVE's specialty line reads Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is SHIRLISA LOVE located near Belleville?
SHIRLISA LOVE currently maps to Belleville, Illinois in this extract.
Can I trust this NPI listing for SHIRLISA LOVE?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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