MRS. SHAWNA JO SURMAN (FNP) – Family Nurse Practitioner, NPI 1790106011

MRS. SHAWNA JO SURMAN (FNP) is a healthcare provider. based in Ballwin, Missouri. specializing in Family Nurse Practitioner. They hold the professional credentials FNP. They hold a License No. 2013026434 (MO). The NPI Number for MRS. SHAWNA JO SURMAN (FNP) is 1790106011

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
MRS. SHAWNA JO SURMAN (FNP)
NPI
1790106011
Phone
(573) 680-2271
Address
13919 REFLECTION CT
Enumeration Date
5 January 2014
Last Update Date
8 September 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6362719100
Graduation Year
2013 (13 years ago)
PAC ID
8022235860
Group Practice PAC ID
7214827922
Professional Enrollment ID
I20140819000292
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:12State licenses:1Digital endpointsOther names

Provider Addresses for MRS. SHAWNA JO SURMAN (FNP)

  • 13919 REFLECTION CT

    APT 635

    BALLWIN, MO 630218041

    Phone: (573) 680-2271

    Type: Mailing

  • 307 NOONAN DR

    PACIFIC, MO 63069

    Phone: (636) 271-9100

    Type: Location

  • 15740 S OUTER 40 RD

    CHESTERFIELD, MO 630172004

    Phone: (636) 237-4700

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $14.

Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.

Last reported payment date: 2023-11-27 • Largest payer in this snapshot: Salix Pharmaceuticals, a division of Bausch Health US, LLC ($14).

Total Amount

$14

General + Research + Ownership

Payments

1

Total payment records

General Amount

$14

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-27

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2014-08-19

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
I20140819000292INurse PractitionerMOTBD

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 63021)

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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: 7214827922View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for MRS. SHAWNA JO SURMAN (FNP)?
MRS. SHAWNA JO SURMAN (FNP) — NPI 1790106011 — is the standard way to identify this listing.
Does the file indicate MRS. SHAWNA JO SURMAN (FNP) is practicing under active NPI?
Directory data currently reports MRS. SHAWNA JO SURMAN (FNP) as active.
What is MRS. SHAWNA JO SURMAN (FNP)'s specialty?
The listing groups MRS. SHAWNA JO SURMAN (FNP) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is MRS. SHAWNA JO SURMAN (FNP) based?
MRS. SHAWNA JO SURMAN (FNP) is tied to Ballwin, Missouri in the data we show; additional addresses may exist on the full record.
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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