Individual provider Active NPI

Shelby Forney, PNP

  • Pediatric Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1073158986
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
71010070B Issued in IN
Practice address
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone
(317) 944-2143
Fax
(317) 944-3107
NPI assigned
Nov 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 28236497A IN
Pediatric Nurse Practitioner 363LP0200X 71010070B IN Primary

Addresses

Primary practice location

705 Riley Hospital Dr
Indianapolis, IN 46202-5109

Mailing address

PO Box 1026
Indianapolis, IN 46206-1026
Phone (317) 777-6435

Other identifiers 1

IdentifierTypeStateIssuer
300038711MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20201002002559 IN Practitioner - Nurse Practitioner 1456770890 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71010070BINMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince Apr 1, 2024 Accepting new patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince Apr 1, 2024 Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients

Locations

13500 N Meridian St
Carmel, IN 46032
Phone (317) 573-7000

13861 Olio Rd
Fishers, IN 46037
Phone (317) 338-7136

250 W 96th St
Ste 520
Indianapolis, IN 46260
Phone (317) 583-3211

8240 Naab Rd
Ste 155
Indianapolis, IN 46260
Phone (317) 338-7760

Interoperability endpoints

  • Direct secure messaging: sforney@direct.iuhealth.org

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": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1073158986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1026",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061026",
            "telephone_number": "317-777-6435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-944-2143",
            "fax_number": "317-944-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNEY",
        "first_name": "SHELBY",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "IN",
            "license": "28236497A",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71010070B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300038711",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.