Shalisa Anne Henson, CNM is a medicare enrolled "Advanced Practice Midwife" in Centralia, Illinois. She graduated from nursing school in 2017 and has 7 years of diverse experience with area of expertise as Certified Nurse Midwife (cnm). She is a member of the group practice The Curators Of The University Of Missouri and her current practice location is
430 N Pleasant Ave, Centralia, Illinois. You can reach out to her office (for appointments etc.) via phone at
(618) 436-8350.
Shalisa Anne Henson is licensed to practice in Illinois (license number 209017353) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1598914905.
Provider's Profile
| Full Name | Shalisa Anne Henson |
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| Gender | Female |
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| Speciality | Certified Nurse Midwife (cnm) |
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| Experience | 7 Years |
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| Location | 430 N Pleasant Ave, Centralia, Illinois |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Shalisa Anne Henson graduated from nursing school in 2017
NPI Data:
- NPI Number: 1598914905
- Provider Enumeration Date: 09/10/2008
- Last Update Date: 05/21/2024
Medicare PECOS Information:
- PECOS PAC ID: 2365500725
- Enrollment ID: I20200413000128
Medical Identifiers
Medical identifiers for Shalisa Anne Henson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1598914905 | NPI | - | NPPES |
| CG2264 | Other | IL | RR GROUP ID |
| 207988001 | Other | IL | MEDICARE PTAN NUMBER |
| P00651305 | Other | IL | RAILROAD MEDICARE |
| 207988 | Other | IL | MEDICARE GROUP NUMBER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363L00000X | Nurse Practitioner | 209007259 (Illinois) | Secondary |
| 367A00000X | Advanced Practice Midwife | 2019040165 (Missouri) | Secondary |
| 367A00000X | Advanced Practice Midwife | 209017353 (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| The Curators Of The University Of Missouri | 4486759560 | 997 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shalisa Anne Henson allows following entities to bill medicare on her behalf.
| Entity Name | The Curators Of The University Of Missouri |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235126921
PECOS PAC ID: 4486759560
Enrollment ID: O20070418000290 |
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| Entity Name | Heartland Women's Healthcare Mo Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1588191431
PECOS PAC ID: 7618236415
Enrollment ID: O20180124003159 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shalisa Anne Henson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Shalisa Anne Henson, CNM
430 N Pleasant Ave,
Centralia, IL 62801-3006
Ph: (618) 436-8350 | Shalisa Anne Henson, CNM
430 N Pleasant Ave,
Centralia, IL 62801-3006
Ph: (618) 436-8350 |
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