Individual provider Active NPI

Derek S Shelton, ARNP

  • Acute Care Nurse Practitioner
  • Newburgh, IN
National Provider Identifier
1063512077
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
71003826A Issued in IN
Practice address
10455 Orthopaedic Dr
Newburgh, IN 47630-7955
Phone
(812) 424-9291
Fax
(812) 421-2722
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71003826A IN
Nurse Practitioner 363L00000X 42960 KY
Acute Care Nurse Practitioner 363LA2100X 42960 KY
Acute Care Nurse Practitioner 363LA2100X 71003826A IN Primary

Addresses

Primary practice location

10455 Orthopaedic Dr
Newburgh, IN 47630-7955

Mailing address

515 Read St
Evansville, IN 47710-1739
Phone (812) 424-9291

Other practice location 1

340 Starlite Dr
Henderson, KY 42420-6102
Phone (812) 424-9291

Other practice location 2

5828 Pearl Dr
Evansville, IN 47712-8116
Phone (812) 424-9291

Other practice location 3

515 Read St
Evansville, IN 47710-1739
Phone (812) 424-9291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070206000534 KY Practitioner - Nurse Practitioner 5890797716 Reassigns benefits to 1 organization
I20120105000120 IN Practitioner - Nurse Practitioner 5890797716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Associates IncGroup PAC ID 2163490285, shared by 4 NPIs, 26 clinicians

Practice addresses (Care Compare)

10455 Orthopaedic Dr
Newburgh, IN 47630-7955
Phone (812) 424-9291

340 Starlite Dr
Henderson, KY 42420-6102
Phone (812) 424-9291

Merit-based Incentive Payment System (MIPS)

Final score
86.82 of 100Reported as group
Quality
85.26
Promoting interoperability
100
Improvement activities
40
Cost
70.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71003826AINMDNurse Practitioner
42960KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates, Inc. Nurse Practitioner Current Accepting new patients
Henderson Acute Care Specialists PLLC Past Accepting new patients

Locations

515 Read St
Evansville, IN 47710
Phone (812) 437-1420

10455 Orthopaedic Dr
Newburgh, IN 47630
Phone (812) 858-2100

340 Starlite Dr
Henderson, KY 42420
Phone (270) 212-3070

Interoperability endpoints

  • Direct secure messaging: dshelton57282@direct.deaconess.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1063512077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 READ ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101739",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10455 ORTHOPAEDIC DR",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476307955",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 Starlite Dr",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "KY",
            "postal_code": "424206102",
            "country_code": "US",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5828 Pearl Dr",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477128116",
            "country_code": "US",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Read St",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477101739",
            "country_code": "US",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "DEREK",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71003826A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "42960",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "42960",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71003826A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.