SHANNON LYNN BACKSTROM CNP NPI 1093787616

NPI Information

NPI: 1093787616
Provider Name: SHANNON LYNN BACKSTROM, CNP
Classification: Nurse Practitioner - 363LP1700X
Entity Type: Individual

Specialization: Perinatal

PECOS Registration: Yes

Address:
1417 S. CLIFF AVE.
STE. 100
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 322-8937
Get Directions

Shannon Lynn Backstrom, CNP is a perinatal nurse practitioner in Sioux Falls, SD. Shannon Lynn Backstrom, CNP NPI is 1093787616. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1417 S. CLIFF AVE.
STE. 100
SIOUX FALLS, SD
ZIP 57105-063
Phone: (605) 322-8937
Fax: (605) 322-8938

The NPI 1093787616 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/7/2006 and was last updated on 10/10/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP1700X	Nurse Practitioner	Perinatal	CP000442	SOUTH DAKOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	248007	OTHER	SOUTH DAKOTA	BLUE CROSS
2	0407827	OTHER	SOUTH DAKOTA	MEDICA
3	248007	OTHER	SOUTH DAKOTA	MIDLANDS CHOICE
4	283761045259	OTHER	SOUTH DAKOTA	PREFERRED ONE
5	HP55697	OTHER	SOUTH DAKOTA	HEALTHPARTNERS
6	83G56BE	OTHER	MINNESOTA	CC SYSTEMS/ BLUE PLUS
7	57105AD05	OTHER	SOUTH DAKOTA	WPS TRICARE
8	9244760	OTHER	SOUTH DAKOTA	DAKOTACARE
9	370624200	OTHER	SOUTH DAKOTA	DEPT OF LABOR
10	10025040700	MEDICAID	NEBRASKA
11	6828300	MEDICAID	SOUTH DAKOTA
12	0503706	MEDICAID	IOWA
13	83G56BE	OTHER	MINNESOTA	BLUE CROSS
14	2387949	OTHER	SOUTH DAKOTA	ARAZ/ AMERICA'S PPO
15	6828302	MEDICAID	SOUTH DAKOTA
16	400070600	MEDICAID	MINNESOTA
17	924114229808	OTHER	MINNESOTA	PRIMEWEST

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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