Christie Deloris Shelly, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

12000-33 Issued in WI

Practice address

235 E State St
Saint Croix Falls, WI 54024-4117

Phone

(715) 483-3261

Fax

(715) 483-0507

NPI assigned

Oct 12, 2018

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 OK, WI2 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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Croix Regional Medical CenterGroup PAC ID 9335032184, 131 clinicians

Burnett Medical Center IncGroup PAC ID 2163314931, shared by 4 NPIs, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Croix Regional Medical Center Hospital, Saint Croix Falls, WI, CCN 521337
• Burnett Medical Center Hospital, Grantsburg, WI, CCN 521331
• Burnett Medical Center Nursing home, CCN 52Z331

Merit-based Incentive Payment System (MIPS)

Final score

73.31 of 100Reported as group

Improvement activities

20

Cost

82.71

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cshelly641903@direct.ochin.org
• Direct secure messaging: cshelly169464@ahs.direct-ci.com

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.

• St. Croix Regional Medical Center

  • Critical Access Hospital
  • Saint Croix Falls, WI
  • NPI 1043240922
  Medicare reassignment Care Compare group NPD
• Burnett Medical Center Inc

  • Critical Access Hospital
  • Grantsburg, WI
  • NPI 1225191687
  Medicare reassignment NPD
• Burnett Medical Center Inc

  • Rural Health Clinic/Center
  • Grantsburg, WI
  • NPI 1356499784
  Medicare reassignment NPD
• Thi Specialists LLC

  • Infectious Disease Physician
  • Tulsa, OK
  • NPI 1952763922
  Medicare reassignment NPD
• Tulsa Hospital Medicine Physicians Group, LLC

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1144982711
  Medicare reassignment NPD
• Burnett Medical Center Inc

  • Skilled Nursing Facility
  • Grantsburg, WI
  • NPI 1487703815
  NPD
• St. Croix Regional Medical Center

  • Rural Health Clinic/Center
  • Balsam Lake, WI
  • NPI 1013423219
  NPD

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

• Burnett Medical Center Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Grantsburg, WI
  • NPI 1003965435

  Nursing home

  Care Compare affiliation
• Burnett Medical Center Inc

  • Critical Access Hospital
  • Grantsburg, WI
  • NPI 1225191687
  Care Compare affiliation
• St. Croix Regional Medical Center

  • Critical Access Hospital
  • Saint Croix Falls, WI
  • NPI 1043240922
  Care Compare affiliation

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

{
    "created_epoch": "1539302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1093280349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E STATE ST",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540244117",
            "telephone_number": "715-483-3261",
            "fax_number": "715-483-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E STATE ST",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540244117",
            "telephone_number": "715-483-3261",
            "fax_number": "715-483-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLY",
        "first_name": "CHRISTIE",
        "middle_name": "DELORIS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-12",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OK",
            "license": "AG10180092",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WI",
            "license": "12000-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gretchen Anne Schoonover, PTA
• William G. Schultz Jr., M.D.
• Ann R Seagren, M.D.
• Lynn Marie Selle, P.T.
• Victoria L Shank, MD
• Vicki L Skarda, D.O.
• Smiles on St. Croix
• Spirit of the Heart Home Care LLC
• Sports & Family Chiropractic SCF LLC
• St Croix Chiropractic and Wellness, LLC

• Gerontology Nurse Practitioner in Saint Croix Falls, WI
• Providers in Saint Croix Falls, WI by specialty
• Gerontology Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.