Individual provider Active NPI

Shelby Layne Blackwell, FNP-C

  • Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1093546756
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5020883 Issued in NC
Practice address
5505 Currituck Dr Ste 200
Wilmington, NC 28403-1155
Phone
(910) 662-7720
Fax
(910) 777-5961
NPI assigned
Aug 13, 2024
Last updated
May 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5020883 NC Primary
Nurse Practitioner 363L00000X 1155658 TX

Addresses

Primary practice location

5505 Currituck Dr Ste 200
Wilmington, NC 28403-1155

Mailing address

1570 Raptor Terrace NE
Bolivia, NC 28422
Phone (210) 488-4023

Other practice location 1

3015 Enterprise Dr
Wilmington, NC 28405-2116
Phone (910) 791-3451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20241219001745 NC Practitioner - Nurse Practitioner 5496282121 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NM Pacs 2 LLCGroup PAC ID 3375892060, 108 clinicians
Inpatient Consultants of North Carolina PCGroup PAC ID 5991720591, 85 clinicians
CS Pacs 3 Southeast LLCGroup PAC ID 8426404302, 129 clinicians

Practice addresses (Care Compare)

2131 S 17TH St
Wilmington, NC 28401-7407
Phone (910) 667-3000

3015 Enterprise Dr
Wilmington, NC 28405-2116
Phone (910) 791-3451

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1155658TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CS Pacs 3 Southeast, LLC CurrentSince Oct 7, 2024 Accepting new patients
NM Pacs 2 LLC CurrentSince Oct 7, 2024 Accepting new patients
Inpatient Consultants of North Carolina, PC Nurse Practitioner CurrentSince Oct 7, 2024 Accepting new patients
Inpatient Consultants of North Carolina, PC Nurse Practitioner CurrentSince Oct 7, 2024 Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

707 N Elm St
High Point, NC 27262
Phone (336) 885-0141

204 E Old Highway 74
Monroe, NC 28112
Phone (704) 283-3066

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

179 Combs St
Sparta, NC 28675
Phone (336) 372-2441

3015 Enterprise Dr
Wilmington, NC 28405
Phone (910) 791-3451

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1093546756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 RAPTOR TERRACE NE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "28422",
            "telephone_number": "210-488-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 CURRITUCK DR STE 200",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284031155",
            "telephone_number": "910-662-7720",
            "fax_number": "910-777-5961"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3015 Enterprise Dr",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284052116",
            "country_code": "US",
            "telephone_number": "910-791-3451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "SHELBY",
        "middle_name": "LAYNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-13",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5020883",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1155658",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.