{
"Npi": {
"NPI": "1578423513",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "STARR",
"FirstName": "SHANNON",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "WALLACH",
"OtherFirstName": "SHANNON",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "FNP-C",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "7620 WINDSOR ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PRAIRIE VILLAGE",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "66208-4022",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "816-808-1856",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7501 METCALF AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OVERLAND PARK",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "66204-2927",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "816-808-1856",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/13/2025",
"LastUpdateDate": "01/21/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "2025013452",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}