Doctor profile · Federal record

Dr. Kenneth Shackelford, DNP, APRN, FNP-BC

Family Nurse Practitioner (CMS: Nurse Practitioner) · Festus, MO

  • NPI 1811774417
  • Accepts Medicare
  • 3 yrs in practice
  • Male
  • Group practice
  • No sanctions

Practice & contact

Operates at 2 locations .

NPPES Updated May 11, 2026
Primary practice
1405 N Truman Blvd
Festus, MO 630281177
(636) 933-2243
Additional location
500 Chesterfield Ctr Ste 250
Chesterfield, MO 630174833
(636) 519-8889
Mailing address
16607 Evergreen Forest Dr
Wildwood, MO 630111800

Credentials & registration

NPPES · NUCC
NPI registered
September 2023 — 3 yrs on file
Year of graduation
2023 — 3 yrs since
Specialty taxonomy
363LF0000X — NUCC code
State license (1)
Missouri #2023036843

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1811774417. Last verified May 11, 2026.

Medicare procedures · 2023

Top services delivered

CMS Provider Utilization
Total services
57
Distinct HCPCS
2
Medicare allowed
$5,396
HCPCS Description Services Patients Avg allowed
99214 Established patient office or other outpatient visit, 30-39 minutes 39 37 $104
99213 Established patient office or other outpatient visit, 20-29 minutes 18 17 $74

In context: peer comparison

Among 12 peers in this city , average services per provider: 60. This provider delivers 1.0× the peer median.

Open Payments

Industry payments received

CMS Open Payments
All-time total
$383
Transactions
6
Manufacturers
2
Payer (manufacturer) Industry Txns Amount
Nevro Corp. 5 $364.21
Curonix LLC 1 $18.50

By nature of payment

Food and Beverage
$215
Travel and Lodging
$168

Hospital affiliations

CMS Hospital Compare

Frequently asked questions

Auto-generated from federal data
What is Dr. Kenneth Shackelford's medical specialty?
Dr. Kenneth Shackelford practices Family Nurse Practitioner in Festus, MO.
Where does Dr. Kenneth Shackelford practice?
Dr. Kenneth Shackelford practices at 1405 N Truman Blvd, Festus, MO 630281177. Office phone: 6369332243.
What is Dr. Kenneth Shackelford's NPI?
Dr. Kenneth Shackelford's National Provider Identifier (NPI) is 1811774417, issued by NPPES.
Does Dr. Kenneth Shackelford accept Medicare assignment?
Yes. Dr. Kenneth Shackelford accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Kenneth Shackelford commonly perform?
Top Medicare-reported procedures in 2023: Established patient office or other outpatient visit (HCPCS 99214); Established patient office or other outpatient visit (HCPCS 99213). Source: CMS Medicare Physician & Other Practitioners file.