Shelley L Clark, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71004374A Issued in IN

Practice address

2142 25TH St Ste I
Columbus, IN 47201-3242

Phone

(812) 375-8810

NPI assigned

Apr 10, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illinois Urgent Care Professionals PLLCGroup PAC ID 9830437946, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Sacred Heart Bay Hospital, Panama City, FL, CCN 100026

Merit-based Incentive Payment System (MIPS)

Final score

93.97 of 100Reported as apm

Quality

85.1

Promoting interoperability

94.69

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sclark23934@edirect.crh.org

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.

• Illinois Urgent Care Professionals PLLC

  • Family Medicine Physician
  • Homewood, IL
  • NPI 1215407812

  IN

  Medicare reassignment Care Compare group NPD
• Columbus Regional Health Physicians, LLC

  • Internal Medicine Physician
  • Columbus, IN
  • NPI 1336510098
  Medicare reassignment NPD
• Columbus Regional Health Physicians, LLC

  • Family Medicine Physician
  • Columbus, IN
  • NPI 1740650225
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

• Bay County Health System, LLC

  • General Acute Care Hospital
  • Panama City, FL
  • NPI 1720078041
  Care Compare affiliation

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1093158925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775383",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606775383",
            "telephone_number": "812-376-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 25TH ST STE I",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472013242",
            "telephone_number": "812-375-8810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3015 10th St Ste A",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "IN",
            "postal_code": "472017091",
            "country_code": "US",
            "telephone_number": "812-372-8883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SHELLEY",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-10",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004374A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sclark23934@edirect.crh.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "815 Schnier St",
            "city": "Columbus",
            "state": "IN",
            "country_code": "US",
            "postal_code": "472012619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gabreille Civiletto, RBT
• Brittany Nicole Clark
• Melissa Clark, 6002172
• Mollie Clark, RBT
• Roy Ellis Clark, M.S., CCC-A
• Taylor Clark, RBT
• Stacey Ann Claycamp
• Clear Chiropractic Columbus, LLC
• Tracey Lynn Clifford, RPH
• Michelle Mona Cline, DNP, FNP-C

• Family Nurse Practitioner in Columbus, IN
• Providers in Columbus, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; 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.