Mrs Shanell Rena Gladson, APRN is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Bartonville, Illinois. She graduated from medical school in 2024 and has 1 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Bespoke Psychiatry and her current practice location is
4615 Correl Ave, Bartonville, Illinois. You can reach out to her office (for appointments etc.) via phone at
(309) 453-0688.
Mrs Shanell Rena Gladson is licensed to practice in Illinois (license number 209031579) 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 1043845084.
Physician's Profile
| Full Name | Mrs Shanell Rena Gladson |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 1 Years |
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| Location | 4615 Correl Ave, Bartonville, 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:
- Mrs Shanell Rena Gladson graduated from medical school in 2024
NPI Data:
- NPI Number: 1043845084
- Provider Enumeration Date: 03/10/2020
- Last Update Date: 11/16/2025
Medicare PECOS Information:
- PECOS PAC ID: 7618492810
- Enrollment ID: I20250421001925
Medical Identifiers
Medical identifiers for Mrs Shanell Rena Gladson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043845084 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2084P0800X | Psychiatry & Neurology - Psychiatry | 209031579 (Illinois) | Primary |
| 163W00000X | Registered Nurse | RN233341 (Arizona) | Secondary |
| 163W00000X | Registered Nurse | 04105255 (Illinois) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | 23341 (Arizona) | Secondary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Bespoke Psychiatry | 3274951744 | 42 |
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. Mrs Shanell Rena Gladson allows following entities to bill medicare on her behalf.
| Entity Name | Bespoke Psychiatry |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1952937104
PECOS PAC ID: 3274951744
Enrollment ID: O20200915002352 |
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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. Mrs Shanell Rena Gladson 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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Mrs Shanell Rena Gladson, APRN
4615 Correl Ave,
Bartonville, IL 61607-2618
Ph: (309) 453-0688 | Mrs Shanell Rena Gladson, APRN
4615 Correl Ave,
Bartonville, IL 61607-2618
Ph: (309) 453-0688 |
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