Individual provider Active NPI

Shelly Lynn Ann Seth, CWOCN, FNP

  • Acute Care Nurse Practitioner
  • Amarillo, TX
National Provider Identifier
1073684353
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP111914 Issued in TX
Practice address
1215 S Coulter St
Suite #301
Amarillo, TX 79106-1758
Phone
(806) 355-9741
Fax
(806) 356-0045
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 255623 TX
Acute Care Nurse Practitioner 363LA2100X AP111914 TX Primary

Addresses

Primary practice location

1215 S Coulter St
Suite #301
Amarillo, TX 79106-1758

Mailing address

PO Box 840026
Dallas, TX 75284-0026
Phone (806) 212-6965

Other practice location 1

1400 S Coulter St
Amarillo, TX 79106-1786
Phone (806) 414-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050919000341 TX Practitioner - Nurse Practitioner 2264465335 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
255623TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center CurrentSince Jan 1, 2020 Accepting new patients
Texas Tech University Health Sciences Center Amarillo CurrentSince Jan 1, 2020 Accepting new patients

Locations

1600 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2000

1400 Wallace Blvd
Amarillo, TX 79106
Phone (806) 354-5585

1400 S Coulter St
Amarillo, TX 79106
Phone (806) 354-5600

Organizations & group practices 2

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1073684353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840026",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840026",
            "telephone_number": "806-212-6965",
            "fax_number": "806-212-6278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 S COULTER ST",
            "address_2": "SUITE #301",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061758",
            "telephone_number": "806-355-9741",
            "fax_number": "806-356-0045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 S Coulter St",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791061786",
            "country_code": "US",
            "telephone_number": "806-414-9100",
            "fax_number": "806-354-5717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SETH",
        "first_name": "SHELLY",
        "middle_name": "LYNN ANN",
        "credential": "CWOCN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "255623",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP111914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.