Individual provider Active NPI

Dawn M Shelby, MSN, ARNP

  • Family Nurse Practitioner
  • Elizabethtown, KY
National Provider Identifier
1093976193
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
46191 Issued in KY
Practice address
1704 N Dixie Hwy # 913
Elizabethtown, KY 42701-9449
Phone
(270) 706-1642
NPI assigned
Jun 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 46191 KY Primary

Addresses

Primary practice location

1704 N Dixie Hwy # 913
Elizabethtown, KY 42701-9449

Mailing address

PO Box 910530
Lexington, KY 40591-0530
Phone (877) 763-6257

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090105000420 KY Practitioner - Nurse Practitioner 2961565759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Company of Tennessee PLLCGroup PAC ID 0345588109, 68 clinicians

Practice addresses (Care Compare)

910 Wallace Ave
Leitchfield, KY 42754-2414
Phone (270) 259-9400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.76 of 100Reported as group
Quality
81.95
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
46191KYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabethtown Emergency Physicians, LLC CurrentSince Aug 1, 2008 Accepting new patients

Locations

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

910 Wallace Ave
Leitchfield, KY 42754
Phone (270) 259-3035

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.

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": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1093976193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910530",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405910530",
            "telephone_number": "877-763-6257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 N DIXIE HWY # 913",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427019449",
            "telephone_number": "270-706-1642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELBY",
        "first_name": "DAWN",
        "middle_name": "M",
        "credential": "MSN, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "46191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.