Individual provider Active NPI

Shelby Louise Tinney, FNP-C

  • Nurse Practitioner
  • Lillington, NC
National Provider Identifier
1033924873
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5021639 Issued in NC
Practice address
100 S 10TH St
Lillington, NC 27546-6690
Phone
(910) 893-4111
Fax
(910) 893-9850
NPI assigned
Feb 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5021639 NC Primary

Addresses

Primary practice location

100 S 10TH St
Lillington, NC 27546-6690

Mailing address

739 Elderberry Dr
Vass, NC 28394-8444
Phone (806) 676-1094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250407001308 NC Practitioner - Nurse Practitioner 4486178902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med First Immediate Care and Family Practice PA 94 clinicians

Practice addresses (Care Compare)

100 S 10TH St
Lillington, NC 27546-6690
Phone (910) 893-4111

Hospital & facility affiliations

  • Betsy Johnson Regional Hospital Hospital, Dunn, NC, CCN 340071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5021639NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Med First Immediate Care & Family Practice, PA CurrentSince Feb 15, 2025 Accepting new patients

Locations

609 Richlands Hwy
Ste 6
Jacksonville, NC 28540
Phone (910) 455-7888

100 S 10th St
Lillington, NC 27546
Phone (910) 893-4111

1616 E Millbrook Rd
Ste 110
Raleigh, NC 27609
Phone (919) 341-4016

3396 Six Forks Rd
Raleigh, NC 27609
Phone (919) 781-8897

Interoperability endpoints

  • Direct secure messaging: shelby.tinney.1@1905.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1033924873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 ELDERBERRY DR",
            "city": "VASS",
            "state": "NC",
            "postal_code": "283948444",
            "telephone_number": "806-676-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S 10TH ST",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275466690",
            "telephone_number": "910-893-4111",
            "fax_number": "910-893-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINNEY",
        "first_name": "SHELBY",
        "middle_name": "LOUISE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5021639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lillington, NC

Sources for this page

Verify at the official NPI Registry.