Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1558898510 Individual Practitioner Female Practitioner

Shaunte Moore , CPNP-PC

Nurse Practitioner - Pediatrics • O Fallon, IL

Professional Overview & Biography Verified Profile Summary

Shaunte Moore, CPNP-PC is a registered healthcare professional specializing in Nurse Practitioner - Pediatrics in O Fallon, IL. Practice services are available at 604 PIERCE BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

604 Pierce Blvd

O Fallon, IL 622692588

Telephone 6182229244
Associated Practice Facility / Clinic
🏢 Ssm Medical Group Facility NPI 1619150703

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Pediatrics in O Fallon, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.5 Yrs
Regional Practice Density
1 Specialists

Practicing in O Fallon, IL (694 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

State License IL 209015873

Definition to come...

Nurse Practitioner - Pediatrics

NUCC Taxonomy Code: 363LP0200X

State License MO 2017000683

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
NPI 1003942145

Doctor of Medicine (M.D.)

Keisha Young , FNP-C

Nurse Practitioner

NPI 1356833941

Family Nurse Practitioner (Certified)

NPI 1366475303

Doctor of Medicine (M.D.)

NPI 1487672903

Doctor of Medicine (M.D.)

Julia Harms , CPNP

Nurse Practitioner - Pediatrics

NPI 1568751253

Certified Pediatric Nurse Practitioner

NPI 1619515384

CPNPPC

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active May 20, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location May 20, 2017

Registered at 604 PIERCE BLVD, O FALLON, IL 622692588 (Tel: 6182229244)

📍
Updated Business Mailing Address May 20, 2017

Registered at 132 RIDGE DR, MARYVILLE, IL 620625681 (Tel: 6184070552)

👤
Provider Name / Credentials Updated May 20, 2017

Recorded as SHAUNTE MOORE, CPNP-PC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 20, 2017

Nurse Practitioner (License #2017000683 in MO)

🟢
Initial NPI Registration & Enumeration May 20, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1558898510
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 20, 2017
Last Update: May 20, 2017
Sole Proprietor: No

Mailing Address

132 Ridge Dr

Maryville, IL 620625681

Phone: 6184070552

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.