Holly Marie Shoulders, RN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3017503 Issued in KY

Practice address

400 Airport Rd
Greenville, KY 42345-2800

Phone

(812) 598-1218

NPI assigned

Jan 22, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Health Deaconess Medical Group IncGroup PAC ID 6103220330, 241 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Baptist Health Deaconess Medical Group Inc

  • Internal Medicine Physician
  • Madisonville, KY
  • NPI 1437730942

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  Nurse Practitioner

  Medicare reassignment NPD
• Baptist Health Deaconess Medical Group Inc

  • Rural Health Clinic/Center
  • Madisonville, KY
  • NPI 1497339667
  NPD
• Baptist Health Deaconess Medical Group Inc

  dba Baptist Health Deaconess Madisonville Hospital Based Providers

  • Hospitalist Physician
  • Madisonville, KY
  • NPI 1972320430

  Nurse Practitioner

  NPD
• Baptist Health Madisonville Inc

  dba Baptist Health Medical Associates

  • Family Medicine Physician
  • Madisonville, KY
  • NPI 1174708259
  NPD (past)

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

{
    "created_epoch": "1642809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1073265864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "956 SKYLINE DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424313245",
            "telephone_number": "812-598-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 AIRPORT RD",
            "city": "GREENVILLE",
            "state": "KY",
            "postal_code": "423452800",
            "telephone_number": "812-598-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOULDERS",
        "first_name": "HOLLY",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-22",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WF0300X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Flight",
            "state": "KY",
            "license": "1110152",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3017503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jan Myers Scott
• Pamela Shelton
• Roberta A Shelton, OTR
• Stephanie Kay Shelton, COTA
• Alexis Leshe Sherwood
• Slobodan B Jugo PSC
• Annette Elaine Smith, RPH
• Robert Lee Smith, PH.D.
• Snyder Chiropractic Center, PSC
• Howard Lee Snyder, D.C.

• Nurse Practitioner in Greenville, KY
• Providers in Greenville, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.