Shelly Crane, AGNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

39760 Issued in ID

Practice address

915 W Emma Ave
Coeur D Alene, ID 83814-2531

Phone

(208) 791-3391

NPI assigned

Jan 2, 2020

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

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1104465558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 N GOVERNMENT WAY # 294",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838153751",
            "telephone_number": "208-791-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W EMMA AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142531",
            "telephone_number": "208-791-3391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANE",
        "first_name": "SHELLY",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "ID",
            "license": "39760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alora Ann Cox
• Christina Crabtree, M.D.
• Duane Eldon Craddock, MD
• Craig W. Wiesenhutter, MD
• Cameron Crandall
• Erika Crawford, DO
• Katherine M Crawford, LCSW
• Desiree Creekmore
• Crescent Moon Counseling, LLC
• Tyler Joel Cress, PHARMD

• Primary Care Nurse Practitioner in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Primary Care Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.