{
  "npi": "1316410046",
  "enumeration_type": "NPI-1",
  "basic": {
    "certification_date": "2025-09-25",
    "credential": "NP-C",
    "enumeration_date": "2019-01-04",
    "first_name": "SHAWN",
    "last_name": "STUTES",
    "last_updated": "2025-09-25",
    "middle_name": "KENNETH",
    "name_prefix": "Mr.",
    "sex": "M",
    "sole_proprietor": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "1250 HIGHWAY 221",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "IRONTON",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "573-315-9706",
      "postal_code": "636509155",
      "state": "MO",
      "telephone_number": "573-315-9706"
    },
    {
      "address_1": "1580 W COLUMBIA ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "FARMINGTON",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "636403512",
      "state": "MO",
      "telephone_number": "573-760-1365"
    }
  ],
  "taxonomies": [
    {
      "code": "363LP0808X",
      "desc": "Nurse Practitioner, Psych/Mental Health",
      "license": "G181662",
      "primary": true,
      "state": "IA",
      "taxonomy_group": ""
    },
    {
      "code": "363LF0000X",
      "desc": "Nurse Practitioner, Family",
      "license": "2018030312",
      "primary": false,
      "state": "MO",
      "taxonomy_group": ""
    },
    {
      "code": "363LF0000X",
      "desc": "Nurse Practitioner, Family",
      "license": "A162766",
      "primary": false,
      "state": "IA",
      "taxonomy_group": ""
    },
    {
      "code": "163W00000X",
      "desc": "Registered Nurse",
      "license": "2011017944",
      "primary": false,
      "state": "MO",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "50",
        "medicare_type": "Nurse Practitioner"
      }
    ]
  }
}