SHANNON VANZUMMEREN (APN) – Family Nurse Practitioner, NPI 1205202074
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for SHANNON VANZUMMEREN (APN)
101 S Division
PO Box 198
Stronghurst, IL 614696146
Phone: (309) 924-2424
Type: Location
855 Illini Dr
Suite 304
Silvis, IL 612822907
Phone: (309) 281-2120
Fax: (309) 281-2129
Type: Location
230 S Main
PO Box 198
Monmouth, IL 61462
Phone: (309) 924-2414
Type: Location
PO BOX 4028
ROCK ISLAND, IL 612044028
Phone: (563) 355-9200
Fax: (563) 355-3419
Type: Mailing
855 ILLINI DR
SUITE 304
SILVIS, IL 612822907
Phone: (309) 281-2120
Fax: (309) 281-2129
Type: Location
PO BOX 198
OQUAWKA, IL 614690198
Phone: (309) 924-2414
Type: Mailing
1204 HIGHWAY 164 E
PO BOX 198
OQUAWKA, IL 614696146
Phone: (309) 867-2202
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: 2024-12-05
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20241205003715 | I | Nurse Practitioner | IL | 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 61469)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IA | |
| Nurse Practitioner, Family Practice, Psychiatry | IL | |
| Clinical Social Worker | IL | |
| Clinical Social Worker | IL | |
| Clinical Social Worker | IL | |
| Nurse Practitioner | IL |
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